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Yang HY, Chou HL, Leow CHW, Kao CC, Daniel D, Jaladara V, Khoe LC, Latha PK, Mahendradhata Y, Nguyen PM, Sirijatuphat R, Soemarko DS, Venugopal V, Zhang K, Lee JKW. Poor personal protective equipment practices were associated with heat-related symptoms among Asian healthcare workers: a large-scale multi-national questionnaire survey. BMC Nurs 2024; 23:145. [PMID: 38429747 PMCID: PMC10905833 DOI: 10.1186/s12912-024-01770-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/28/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND It is pertinent to understand the perceptions of healthcare workers (HCWs) with their associated personal protective equipment (PPE) usage and heat strain symptoms experienced to effectively combat the negative effects of heat stress during treatment and care activities. METHODS We evaluated the associated heat stress perceived by HCWs across Asia and validated a questionnaire on perceptions of heat stress, associated PPE usage, and heat strain symptoms experienced. The questionnaire was administered to 3,082 HCWs in six Asian regions. Factor analyses, including Cronbach's alpha, assessed the questionnaire's validity and reliability. Structural equation modelling analysed the effects of knowledge, attitudes and practices, and heat strain symptoms. RESULTS The questionnaire was found to be reliable in assessing HCWs' knowledge, and attitudes and practices towards heat stress and PPE usage (both Cronbach's alpha = 0.9), but not heat strain symptoms (Cronbach's alpha = 0.6). Despite knowledge of heat stress, HCWs had negative attitudes and practices regarding PPE usage (β1 = 0.6, p < 0.001). Knowledge (path coefficient = 0.2, p < 0.001), and negative attitudes and practices (path coefficient = 0.2, p < 0.001) of HCWs towards heat stress and PPE usage adversely affected symptoms experienced. CONCLUSIONS The questionnaire was not reliable in assessing symptoms. HCWs should, nevertheless, still self-assess their symptoms for early detection of heat strain. To effectively attenuate heat strain, understanding HCWs' attitudes and practices towards PPE usage should guide policymakers in implementing targeted heat management strategies.
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Affiliation(s)
- Hsiao-Yu Yang
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, 10055, Taipei, Taiwan
- Department of Public Health, National Taiwan University College of Public Health, 10055, Taipei, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, 100225, Taipei, Taiwan
- Population Health Research Center, National Taiwan University, 10617, Taipei City, Taiwan
| | - Hsiu-Ling Chou
- Department of Nursing, Asia Eastern University of Science and Technology, 220303, New Taipei City, Taiwan
- Department of Nursing, Far Eastern Memorial Hospital, 220216, New Taipei City, Taiwan
| | - Clarence Hong Wei Leow
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, 117593, Singapore, Singapore
- Campus for Research Excellence and Technological Enterprise (CREATE), National University of Singapore, 138602, Singapore, Singapore
| | - Ching-Chiu Kao
- Department of Nursing, Wan Fang Hospital, Taipei Medical University, 116079, Taipei, Taiwan
- School of Nursing, College of Nursing, Taipei Medical University, 110301, Taipei, Taiwan
| | - D Daniel
- Department of Health Behaviour, Environment and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, 55281, Yogyakarta, Indonesia
| | - Vena Jaladara
- Department of Health Behaviour, Environment and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, 55281, Yogyakarta, Indonesia
| | - Levina Chandra Khoe
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, 10430, Jakarta, Indonesia
| | - P K Latha
- Sri Ramachandra Institute of Higher Education & Research, 600116, Chennai, Tamil Nadu, India
| | - Yodi Mahendradhata
- Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, 55281, Yogyakarta, Indonesia
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, 55281, Yogyakarta, Indonesia
| | - Phuong Minh Nguyen
- Department of Military Occupational Medicine, Vietnam Military Medical University, Hanoi, Vietnam
| | - Rujipas Sirijatuphat
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 10700, Bangkok, Thailand
| | - Dewi Sumaryani Soemarko
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, 10430, Jakarta, Indonesia
| | - Vidhya Venugopal
- Sri Ramachandra Institute of Higher Education & Research, 600116, Chennai, Tamil Nadu, India
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, 12144, Rensselaer, NY, USA
| | - Jason Kai Wei Lee
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, 117593, Singapore, Singapore.
- Campus for Research Excellence and Technological Enterprise (CREATE), National University of Singapore, 138602, Singapore, Singapore.
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, 117593, Singapore, Singapore.
- Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine, National University of Singapore, Block MD9, 2 Medical Drive Level 4, 117593, Singapore, Singapore.
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Vidal GA, Jain N, Fisher A, Sheinson D, Lofgren KT, Ma E, Yu E, Comment L, Miksad R, Sincan M, Martin RL, Zuniga R, Daniel D. Racial and Ethnic Inequities at the Practice and Physician Levels in Timely Next-Generation Sequencing for Patients With Advanced Non-Small-Cell Lung Cancer Treated in the US Community Setting. JCO Oncol Pract 2024; 20:370-377. [PMID: 38194619 DOI: 10.1200/op.23.00253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/13/2023] [Accepted: 11/16/2023] [Indexed: 01/11/2024] Open
Abstract
PURPOSE Racial/ethnic inequities in next-generation sequencing (NGS) were examined for patients with advanced non-small-cell lung cancer (aNSCLC) at the practice and physician levels to inform policies to improve equitable quality of care. METHODS This retrospective study used a nationwide electronic health record-derived deidentified database for patients with aNSCLC diagnosed between April 2018 and March 2022 in the community setting. Timely NGS was an NGS result between initial diagnosis and ≤60 days after advanced diagnosis. We studied how inequities were driven by (1) non-Latinx Black (Black) and Latinx patient under-representation at high testing practices versus (2) Black and Latinx patients being tested at lower rates than non-Latinx White (White) patients, even at the same practice. We defined these two concepts as across inequity and within inequity, respectively, with total inequity as their summation. Mean percentage point inequities were estimated using a Bayesian approach. RESULTS A total of 12,045 patients (9,981 White; 1,528 Black; 536 Latinx) met study criteria. At the practice level, versus White patients, the mean percentage point difference in NGS testing total inequity was 7.49 for Black and 8.26 for Latinx. Within- and across-practice inequities contributed to total inequity in NGS testing for Black (48% v 52%) and Latinx patients (60% v 40%). At the physician level, versus White patients, the mean percentage point difference in total inequity was 7.73 for Black and 8.81 for Latinx patients. Within- versus across-physician inequities contributed to total inequity for Black and Latinx patients (77% v 23% and 67% v 33%). CONCLUSION Within-practice, across-practice, and across-physician inequities were main contributors to total inequity in NGS testing, requiring a suite of interventions to effectively address inequities.
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Affiliation(s)
- Gregory A Vidal
- West Cancer Center and Research Institute, Memphis, TN
- OneOncology, Nashville, TN
| | | | | | | | | | - Esprit Ma
- Genentech, Inc, South San Francisco, CA
| | - Elaine Yu
- Genentech, Inc, South San Francisco, CA
| | | | | | | | | | - Richard Zuniga
- OneOncology, Nashville, TN
- New York Cancer and Blood Specialists, Port Jefferson Station, NY
| | - Davey Daniel
- OneOncology, Nashville, TN
- Tennessee Oncology, Nashville, TN
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Vansteenkiste JF, Naidoo J, Faivre-Finn C, Özgüroğlu M, Villegas A, Daniel D, Murakami S, Hui R, Lee KH, Cho BC, Kubota K, Broadhurst H, Wadsworth C, Newton M, Thiyagarajah P, Antonia SJ. Symptomatic Pneumonitis With Durvalumab After Concurrent Chemoradiotherapy in Unresectable Stage III NSCLC. JTO Clin Res Rep 2024; 5:100638. [PMID: 38455595 PMCID: PMC10918565 DOI: 10.1016/j.jtocrr.2024.100638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/05/2023] [Accepted: 01/11/2024] [Indexed: 03/09/2024] Open
Abstract
Introduction In the placebo-controlled, phase 3 PACIFIC trial, durvalumab significantly prolonged progression-free survival (PFS) (p < 0.0001) and overall survival (OS) (p = 0.00251) in patients with unresectable stage III NSCLC and no progression after platinum-based concurrent chemoradiotherapy (cCRT). Pneumonitis or radiation pneumonitis (PRP) was common in both arms. We report exploratory analyses evaluating the association of symptomatic (grade ≥2) PRP (G2+PRP) with baseline factors and clinical outcomes. Methods Patients with WHO performance status of 0 or 1 were randomized (2:1) to 12 months of durvalumab or placebo, 1 to 42 days after cCRT. Associations between baseline factors and on-study G2+PRP in durvalumab-treated patients were investigated using univariate and multivariate logistic regression. PFS and OS were analyzed using Cox proportional hazards models adjusted for time-dependent G2+PRP plus covariates for randomization stratification factors without and with additional baseline factors. Results On-study G2+PRP occurred in 94 of 475 (19.8%) and 33 of 234 patients (14.1%) on durvalumab and placebo, respectively (median follow-up, 25.2 mo); grade greater than or equal to 3 PRP was uncommon (4.6% and 4.7%, respectively). Time to onset and resolution of G2+PRP was similar with durvalumab and placebo. Univariate and multivariate analyses identified patients treated in Asia, those with stage IIIA disease, those with performance status of 1, and those who had not received induction chemotherapy as having a higher risk of G2+PRP. PFS and OS benefit favoring durvalumab versus placebo was maintained regardless of time-dependent G2+PRP. Conclusions Factors associated with higher risk of G2+PRP with durvalumab after cCRT were identified. Clinical benefit was maintained regardless of on-study G2+PRP, suggesting the risk of this event should not deter the use of durvalumab in eligible patients with unresectable stage III NSCLC.
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Affiliation(s)
- Johan F. Vansteenkiste
- Respiratory Oncology Unit and Trial Unit, Department of Respiratory Diseases, University Hospitals KU Leuven, Leuven, Belgium
| | - Jarushka Naidoo
- Department of Medicine, Sidney Kimmel Comprehensive Cancer Center and Bloomberg–Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University, Baltimore, Maryland
- Department of Medicine, Beaumont Hospital and RCSI University of Health Sciences, Dublin, Ireland
| | - Corinne Faivre-Finn
- Division of Cancer Sciences, and Clinical Oncology, The University of Manchester and The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Mustafa Özgüroğlu
- Division of Medical Oncology, Istanbul University − Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - Augusto Villegas
- Hematology and Oncology, Cancer Specialists of North Florida, Jacksonville, Florida
| | - Davey Daniel
- Oncology, Tennessee Oncology, Chattanooga, Tennessee, and Sarah Cannon Research Institute, Nashville, Tennessee
| | - Shuji Murakami
- Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Rina Hui
- Medical Oncology, Westmead Hospital and the University of Sydney, Sydney, NSW, Australia
| | - Ki Hyeong Lee
- Internal Medicine Department, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Byoung Chul Cho
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Nippon Medical School Hospital, Tokyo, Japan
| | | | - Catherine Wadsworth
- Global Medicines Development, AstraZeneca, Alderley Park, United Kingdom
- Current affiliation: Freelancer in the pharmaceutical industry
| | - Michael Newton
- Late Development Oncology, AstraZeneca, Gaithersburg, Maryland
| | - Piruntha Thiyagarajah
- Late Development Oncology, AstraZeneca, Cambridge, United Kingdom
- Current affiliation: Immunocore, Abingdon, United Kingdom
| | - Scott J. Antonia
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
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Stricker T, Jain N, Ma E, Yu E, Wang R, Schuldt R, Price R, Szado T, Sussell J, Ogale S, Lin V, Arrowsmith E, Slater D, Vaena D, Staszewski H, Fang B, Seneviratne L, Daniel D. Clinical Value of Timely Targeted Therapy for Patients With Advanced Non-Small Cell Lung Cancer With Actionable Driver Oncogenes. Oncologist 2024:oyae022. [PMID: 38417095 DOI: 10.1093/oncolo/oyae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/11/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND A recent real-world study observed that 24% of patients with advanced non-small cell lung cancer (aNSCLC) with actionable driver oncogenes (ADOs) initiated nontargeted therapies before biomarker test results became available. This study assessed the clinical impact of the timing of first-line (1L) targeted therapies (TTs) in aNSCLC. MATERIALS AND METHODS This retrospective analysis of a nationwide electronic health record-derived deidentified database included patients aged ≥18 years diagnosed with aNSCLC with ADOs (ALK, BRAF, EGFR, RET, MET, ROS-1, and NTRK) from January 1, 2015, to October 18, 2022, by biomarker testing within 90 days after advanced diagnosis and received 1L treatment. Cohorts were defined by treatment patterns ≤42 days after test results: "Upfront TT" received 1L TT ≤42 days; "Switchers" initiated 1L non-TT before or after testing but switched to TT ≤42 days; and "Non-switchers" initiated non-TT before or after testing and did not switch at any time. Adjusted multivariate Cox regression evaluated real-world progression-free survival, real-world time to next treatment or death, and real-world overall survival. RESULTS A total of 3540 patients met the study criteria; 78% were treated in a community setting, and 50% underwent next-generation sequencing (NGS). There was no significant difference in outcomes between Switchers and Upfront TT; inferior outcomes were observed in Non-switchers versus Upfront TT. CONCLUSION Our findings demonstrated improved outcomes with upfront 1L TT versus non-TT in patients with aNSCLC with ADOs and observed timely switching to TT after biomarker test result had similar outcomes to Upfront TT. Opportunities remain to improve the use of NGS for early ADO identification and determination of 1L TT.
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Affiliation(s)
- Thomas Stricker
- Tennessee Oncology, Nashville, TN, USA
- OneOncology LLC, Nashville, TN, USA
| | | | - Esprit Ma
- Genentech, Inc., South San Francisco, CA, USA
| | - Elaine Yu
- Genentech, Inc., South San Francisco, CA, USA
| | | | | | | | - Tania Szado
- Genentech, Inc., South San Francisco, CA, USA
| | | | | | - Victor Lin
- OneOncology LLC, Nashville, TN, USA
- Mary Bird Perkins Cancer Center, Baton Rouge, LA, USA
| | - Edward Arrowsmith
- Tennessee Oncology, Nashville, TN, USA
- OneOncology LLC, Nashville, TN, USA
| | - Dennis Slater
- OneOncology LLC, Nashville, TN, USA
- Eastern Connecticut Hematology and Oncology, Norwich, CT, USA
| | - Daniel Vaena
- OneOncology LLC, Nashville, TN, USA
- West Cancer Center & Research Institute, Germantown, TN, USA
| | - Harry Staszewski
- OneOncology LLC, Nashville, TN, USA
- New York Cancer & Blood Specialists, Port Jefferson Station, NY, USA
| | - Bruno Fang
- OneOncology LLC, Nashville, TN, USA
- Astera Cancer Care, East Brunswick, NJ, USA
| | - Lasika Seneviratne
- OneOncology LLC, Nashville, TN, USA
- Los Angeles Cancer Network, Los Angeles, CA, USA
| | - Davey Daniel
- Tennessee Oncology, Nashville, TN, USA
- OneOncology LLC, Nashville, TN, USA
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Purwandari R, Daniel D, Hafidz F. Analysis of water, sanitation, and hygiene facilities using the WASH-FIT approach and its relation to patient satisfaction and maternal mortality at hospitals in Indonesia. Front Public Health 2024; 12:1322470. [PMID: 38362217 PMCID: PMC10867246 DOI: 10.3389/fpubh.2024.1322470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/15/2024] [Indexed: 02/17/2024] Open
Abstract
Introduction The provision of Water, Sanitation, and Hygiene (WASH) is critical to reducing infection and enhancing the quality of health care services. The study aims to assess WASH facilities in Indonesian hospitals using the Water, Sanitation, and Hygiene Facility Improvement Tool (WASH-FIT) approach and examine their association with customer satisfaction and maternal mortality owing to infection. Methods We utilized the national scale Health Facilities Research dataset in Indonesian hospitals in 2019. WASH status is determined using WASH-FIT indicators, i.e., water, sanitation, waste management, hand hygiene, environmental cleaning, and management services, and then divided into three levels: poor, adequate, and good categories. Results The majority of hospitals in Indonesia had a good category, i.e., the range of hospitals with a good category was 79-97% nationally, in 6 aspects: water, sanitation, hand hygiene, environmental cleaning, and management services, except for waste management services (13%). Good WASH service facilities are more frequently found in government hospitals than in private and specialized hospitals, while lower-level hospitals tend to have poor levels of all WASH-FIT indicators. There are significant relationships between adequate sanitation services (β = 0.724), adequate and good categories of hand hygiene services (β = 0.712 and 0.866, respectively), environmental cleaning (β = -0.501 and -0.503, respectively), and management (β = -0.645 and 0.446, respectively), with the proportion of maternal mortality owing to infection. Furthermore, there was no relationship between WASH-FIT indicators and patient satisfaction, except for good hand hygiene services (β = 0.453). Discussion Despite good conditions in almost all WASH-FIT indicators, the improvement of waste management is urgently needed to improve the WASH services in hospitals in Indonesia, as also found in other developing countries.
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Affiliation(s)
- Rina Purwandari
- Master of Public Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - D. Daniel
- Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Firdaus Hafidz
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Pakaya R, Daniel D, Widayani P, Utarini A. Spatial model of Dengue Hemorrhagic Fever (DHF) risk: scoping review. BMC Public Health 2023; 23:2448. [PMID: 38062404 PMCID: PMC10701958 DOI: 10.1186/s12889-023-17185-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Creating a spatial model of dengue fever risk is challenging duet to many interrelated factors that could affect dengue. Therefore, it is crucial to understand how these critical factors interact and to create reliable predictive models that can be used to mitigate and control the spread of dengue. METHODS This scoping review aims to provide a comprehensive overview of the important predictors, and spatial modelling tools capable of producing Dengue Haemorrhagic Fever (DHF) risk maps. We conducted a methodical exploration utilizing diverse sources, i.e., PubMed, Scopus, Science Direct, and Google Scholar. The following data were extracted from articles published between January 2011 to August 2022: country, region, administrative level, type of scale, spatial model, dengue data use, and categories of predictors. Applying the eligibility criteria, 45 out of 1,349 articles were selected. RESULTS A variety of models and techniques were used to identify DHF risk areas with an arrangement of various multiple-criteria decision-making, statistical, and machine learning technique. We found that there was no pattern of predictor use associated with particular approaches. Instead, a wide range of predictors was used to create the DHF risk maps. These predictors may include climatology factors (e.g., temperature, rainfall, humidity), epidemiological factors (population, demographics, socio-economic, previous DHF cases), environmental factors (land-use, elevation), and relevant factors. CONCLUSIONS DHF risk spatial models are useful tools for detecting high-risk locations and driving proactive public health initiatives. Relying on geographical and environmental elements, these models ignored the impact of human behaviour and social dynamics. To improve the prediction accuracy, there is a need for a more comprehensive approach to understand DHF transmission dynamics.
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Affiliation(s)
- Ririn Pakaya
- Doctoral Program in Public Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
- Department of Public Health, Public Health Faculty, Universitas Gorontalo, Gorontalo, Indonesia.
| | - D Daniel
- Department of Health Behaviour, Environment and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Prima Widayani
- Department of Geographic Information Science, Faculty of Geography, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Adi Utarini
- Doctoral Program in Public Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Daddam JR, Daniel D, Kra G, Pelech I, Portnick Y, Moallem U, Lavon Y, Zachut M. Plant polyphenol extract supplementation affects performance, welfare, and the Nrf2-oxidative stress response in adipose tissue of heat-stressed dairy cows. J Dairy Sci 2023; 106:9807-9821. [PMID: 37641328 DOI: 10.3168/jds.2023-23549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/21/2023] [Indexed: 08/31/2023]
Abstract
We examined the effects of a supplement of plant polyphenols extracts of green tea, capsicum, and fenugreek, and electrolytes ([Na+, K+]; AXT, Axion ThermoPlus, CCPA, France] during summer heat load on production, welfare, and oxidative stress proteins in adipose tissue (AT) of dairy cows. A total of 42 multiparous mid-lactation cows were divided into 3 groups during summer, and were fed for 2 wk either a standard milking cow diet (CTL, n = 14) or diets supplemented with 100 g/d of AXT (100AXT, n = 14), or 150 g/d of AXT (150AXT, n = 14), while being cooled 5 times a day. Then, half of the cows from each dietary treatment were cooled (CL) or not cooled (NCL) for 2 wk, after which the cooled and uncooled groups were switched for additional 2 wk. Cows were milked 3 times a day, and milk composition was analyzed at the end of each 2-wk period. Vaginal temperature (VT) was measured for 3 consecutive days in each period. Biopsies of subcutaneous AT were taken from 10 NCL cows (5 each of CTL and 150AXT) at the end of the period and examined by liquid chromatography-tandem mass spectrometry proteomics analysis. Data were analyzed with PROC MIXED of SAS (version 9.2, SAS Institute Inc.). The model included the effects of dietary treatment, cooling regimen, period, and their interactions. Protein and mRNA abundances and proteomic data (P ≤ 0.05 and fold change [FC] ± 1.5) were analyzed by t-test. Milk yields and 4% fat-corrected milk (FCM) were higher in 100AXT than in CTL; milk components were not different. Dry matter intake (DMI) was higher in 100AXT than in CTL. The effect of cooling and the interactions of period × cooling were significant for DMI, 4% FCM, energy-corrected milk, and milk/DMI. The proportion of time that VT was >39°C was lower in 100AXT and in 150AXT than in CTL. Daily rumination time was greater in 150AXT than in CTL, and lying time was greater in 100AXT and 150AXT than in CTL. Proteomics of AT demonstrated that 150AXT had increased abundances of peroxidasin (FC = 1.6), microsomal glutathione S-transferase 2 (FC = 2.5), and heme oxygenase 1 (FC = 3.6) compared with CTL. Top enriched canonical pathways included acute phase response signaling, Nrf2-mediated oxidative stress response, and lipopolysaccharide (LPS)/IL-1-mediated inhibition of RXR function. Immunoblots of AT showed a higher abundance of the transient receptor potential vanilloid 1 and of LPS binding protein in AT of 150AXT compared with CTL. Supplementation of AXT increased DMI, milk, and 4% FCM, lowered VT, improved welfare indices, and enriched the AT with Nrf2-oxidative stress response and acute phase response proteins in heat-stressed dairy cows.
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Affiliation(s)
- J R Daddam
- Department of Ruminant Science, Institute of Animal Science, Volcani Institute, Rishon LeZion 7505101, Israel
| | - D Daniel
- Department of Ruminant Science, Institute of Animal Science, Volcani Institute, Rishon LeZion 7505101, Israel; Department of Animal Science, the Robert H. Smith Faculty of Agriculture, Food and Environment, the Hebrew University of Jerusalem, Rehovot 76100001, Israel
| | - G Kra
- Department of Ruminant Science, Institute of Animal Science, Volcani Institute, Rishon LeZion 7505101, Israel; Department of Animal Science, the Robert H. Smith Faculty of Agriculture, Food and Environment, the Hebrew University of Jerusalem, Rehovot 76100001, Israel
| | - I Pelech
- Department of Cattle, Extension Service, Ministry of Agriculture, Rishon LeZion 7505101, Israel
| | - Y Portnick
- Department of Ruminant Science, Institute of Animal Science, Volcani Institute, Rishon LeZion 7505101, Israel
| | - U Moallem
- Department of Ruminant Science, Institute of Animal Science, Volcani Institute, Rishon LeZion 7505101, Israel
| | - Y Lavon
- Israeli Cattle Board Association, Caesarea 38900, Israel
| | - M Zachut
- Department of Ruminant Science, Institute of Animal Science, Volcani Institute, Rishon LeZion 7505101, Israel.
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Schwartzberg L, Daniel D, Vaena D, Slater D, Staszewski H, Fang B, Seneviratne L, Yu E, Price R, Szado T, Meyer CS, Shah A, Ma E. Improving biomarker testing in advanced non-small-cell lung cancer and metastatic colorectal cancer: experience from a large community oncology network in the USA. Future Oncol 2023; 19:1397-1414. [PMID: 37318757 DOI: 10.2217/fon-2022-1216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
Aim: Biomarker testing detects actionable driver mutations to inform first-line treatment in advanced non-small-cell lung cancer (aNSCLC) and metastatic colorectal cancer (mCRC). This study evaluated biomarker testing in a nationwide database (NAT) versus the OneOncology (OneOnc) community network. Patients & methods: Patients with aNSCLC or mCRC with ≥1 biomarker test in a de-identified electronic health record-derived database were evaluated. OneOnc oncologists were surveyed. Results: Biomarker testing rates were high and comparable between OneOnc and NAT; next-generation sequencing (NGS) rates were higher at OneOnc. Patients with NGS versus other biomarker testing were more likely to receive targeted treatment. Operational challenges and insufficient tissue were barriers to NGS testing. Conclusion: Community cancer centers delivered personalized healthcare through biomarker testing.
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Affiliation(s)
- Lee Schwartzberg
- Renown Health Institute for Cancer, Reno, NV 89502, USA
- OneOncology, Inc., Nashville, TN 37219, USA
| | - Davey Daniel
- OneOncology, Inc., Nashville, TN 37219, USA
- Tennessee Oncology, Nashville, TN 37203, USA
| | - Daniel Vaena
- OneOncology, Inc., Nashville, TN 37219, USA
- West Cancer Center & Research Institute, Germantown, TN 38138, USA
| | - Dennis Slater
- OneOncology, Inc., Nashville, TN 37219, USA
- Eastern Connecticut Hematology & Oncology, Norwich, CT 06360, USA
| | - Harry Staszewski
- OneOncology, Inc., Nashville, TN 37219, USA
- New York Cancer & Blood Specialists, Port Jefferson Station, NY 11776, USA
| | - Bruno Fang
- OneOncology, Inc., Nashville, TN 37219, USA
- Astera Cancer Care, East Brunswick, NJ 08816, USA
| | - Lasika Seneviratne
- OneOncology, Inc., Nashville, TN 37219, USA
- Los Angeles Cancer Network, Los Angeles, CA 90017, USA
| | - Elaine Yu
- Genentech, Inc., South San Francisco, CA 94080, USA
| | | | - Tania Szado
- Genentech, Inc., South San Francisco, CA 94080, USA
| | - Craig S Meyer
- Janssen Pharmaceuticals of Johnson & Johnson, South San Francisco, CA 94080, USA
| | - Anuj Shah
- Gilead Sciences, Inc., Foster City, CA 94404, USA
| | - Esprit Ma
- Genentech, Inc., South San Francisco, CA 94080, USA
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Daniel D, Nastiti A, Surbakti HY, Dwipayanti NMU. Access to inclusive sanitation and participation in sanitation programs for people with disabilities in Indonesia. Sci Rep 2023; 13:4310. [PMID: 36922602 PMCID: PMC10017721 DOI: 10.1038/s41598-023-30586-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
Access to inclusive sanitation for people with disabilities (PWDs) remains a global challenge, including in Indonesia, where 10-15% of its population is disabled. Inclusive sanitation facilities can be achieved when PWDs are involved in the sanitation-related decision-making process, e.g., designing toilet that meets their needs. This study aims to investigate the situation of the sanitation facility in houses of PWDs and understand knowledge, attitude, and practices related to PWD participation in sanitation programs using a case study in two provinces in Indonesia: Nusa Tenggara Barat and Nusa Tenggara Timur. Quantitative data were taken from 129 PWD households, and qualitative data were from in-depth interviews with relevant stakeholders. The latter was presented in a causal loop diagram. Less than 5% had inclusive sanitation at home, mainly due to no supportive tools and bins. The knowledge levels related to sanitation and PWDs participation in sanitation programs were relatively low. Economic condition was one of the barriers for PWDs to participate in the sanitation program. Statistical analysis found that a higher household head education level was associated with a more positive attitude and higher PWD participation in sanitation programs. Although Indonesian law supports PWD participation, the implementation remains a challenge. This study also underlines the need for capacity building in facilitating PWDs' involvement in sanitation programs and community meetings. Finally, barriers to PWD participation can come from different levels and actors, e.g., the family, the community, the district level, and the PWD itself, indicating the need to involve actors at all levels to enhance PWD participation in the sanitation program that leads to inclusive sanitation facilities for all groups.
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Affiliation(s)
- D Daniel
- Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Anindrya Nastiti
- Faculty of Civil and Environmental Engineering, Institut Teknologi Bandung, Bandung, Indonesia. .,Center for Environmental Studies, Institut Teknologi Bandung, Bandung, Indonesia.
| | - Hana Yesica Surbakti
- Department of Public Health, The Graduate School, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Ni Made Utami Dwipayanti
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Indonesia
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Daniel D, Qaimamunazzala H, Prawira J, Siantoro A, Sirait M, Tanaboleng YB, Padmawati RS. Interactions of Factors Related to the Stunting Reduction Program in Indonesia: A Case Study in Ende District. Int J Soc Determinants Health Health Serv 2023:27551938231156024. [PMID: 36788218 DOI: 10.1177/27551938231156024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Previous stunting-related studies focus more on causes or determinants of stunting. Little is known about factors contributing to the success of stunting reduction programs. This study aims to fill those gaps using a case study from Ende District, Province of Nusa Tenggara Timur, Indonesia. A group model-building workshop with stunting-related stakeholders was conducted in November 2021. The system dynamic approach in the form of a causal loop diagram was used. Five variables related to the stunting reduction program were included in the analysis: the budget for the stunting reduction program; stunting-related stakeholder's cooperation and coordination; sufficient water supply; the ability of the related stakeholders to execute the program; and water, sanitation, and hygiene-related behavior. We found that the budget for the program and the cooperation and coordination between stakeholders were the most influential variables in the system. The feedback loop between these 2 variables was also the most prominent in the system, suggesting that sufficient funding and strong collaboration between stakeholders could lead to successful stunting reduction programs. Finally, this study implies that the stunting reduction programs in developing countries should be seen holistically and improvement should be conducted in all aspects, including financial, institutional, environmental, technical, and social.
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Affiliation(s)
- D Daniel
- Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Hayu Qaimamunazzala
- Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Ayu Siantoro
- Department of Ministry Quality and Impact, Health Units, 625679Wahana Visi Indonesia, Tangerang Selatan, Indonesia
| | - Mita Sirait
- Department of Ministry Quality and Impact, Health Units, 625679Wahana Visi Indonesia, Tangerang Selatan, Indonesia
| | | | - Retna Siwi Padmawati
- Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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11
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Johnson M, Langdon R, Ellison D, Spira A, Amin H, Castine M, Daniel D, Larson T, Sohoni S, Chen YC, Hayes J, Yang L, Masciari S, Wang X, Toya S. EP08.02-111 RMC-4630, a SHP2 Inhibitor, in Combination with Sotorasib for Advanced KRASG12C NSCLC After Failure of Prior Standard Therapies: A Phase 2 Trial. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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12
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Schwartzberg LS, Li G, Tolba K, Bourla AB, Schulze K, Gadgil R, Fine A, Lofgren KT, Graf RP, Oxnard GR, Daniel D. Complementary Roles for Tissue- and Blood-Based Comprehensive Genomic Profiling for Detection of Actionable Driver Alterations in Advanced NSCLC. JTO Clin Res Rep 2022; 3:100386. [PMID: 36089920 PMCID: PMC9460153 DOI: 10.1016/j.jtocrr.2022.100386] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/19/2022] [Accepted: 07/23/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Whereas tumor biopsy is the reference standard for genomic profiling of advanced NSCLC, there are now multiple assays approved by the Food and Drug Administration for liquid biopsy testing of circulating tumor DNA. Here, we study the incremental value that liquid biopsy comprehensive genomic profiling (CGP) adds to tissue molecular testing. Methods Patients with metastatic NSCLC were enrolled in a prospective diagnostic study to receive circulating tumor DNA CGP; tissue CGP was optional in addition to their standard tissue testing. Focusing on nine genes listed per the National Comprehensive Cancer Network (NCCN) guidelines, liquid CGP was compared with available tissue testing results across three subcohorts: tissue CGP, standard-of-care testing of up to five biomarkers, or no tissue testing. Results A total of 515 patients with advanced nonsquamous NSCLC received liquid CGP. Among 131 with tissue CGP results, NCCN biomarkers were detected in 86 (66%) with tissue CGP and 56 (43%) with liquid CGP (p < 0.001). Adding liquid CGP to tissue CGP detected no additional patients with NCCN biomarkers, whereas tissue CGP detected NCCN biomarkers in 30 patients (23%) missed by liquid CGP. Studying 264 patients receiving tissue testing of up to five genes, 102 (39%) had NCCN biomarkers detected in tissue, with an additional 48 (18%) detected using liquid CGP, including 18 with RET, MET, or ERBB2 drivers not studied in tissue. Conclusions For the detection of patients with advanced nonsquamous NSCLC harboring 9 NCCN biomarkers, liquid CGP increases detection in patients with limited tissue results, but does not increase detection in patients with tissue CGP results available. In contrast, tissue CGP can add meaningfully to liquid CGP for detection of NCCN biomarkers and should be considered as a follow-up when an oncogenic driver is not identified by liquid biopsy.
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Affiliation(s)
| | - Gerald Li
- Foundation Medicine, Clinical Development, Cambridge, Massachusetts
| | - Khaled Tolba
- Foundation Medicine, Clinical Development, Cambridge, Massachusetts
| | | | - Katja Schulze
- Genentech, Inc., Oncology Biomarker Development & Medical Affairs, South San Francisco, California
| | - Rujuta Gadgil
- Foundation Medicine, Clinical Operations, Cambridge, Massachusetts
| | - Alexander Fine
- Foundation Medicine, Cancer Genomics Research, Cambridge, Massachusetts
| | | | - Ryon P. Graf
- Foundation Medicine, Clinical Development, Cambridge, Massachusetts
| | | | - Davey Daniel
- Tennessee Oncology, Medical Oncology, Chattanooga, Tennessee
- Corresponding author. Address for correspondence: Davey Daniel, MD, Tennessee Oncology, 605 Glenwood Drive, Suite 200, Chattanooga, TN.
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Daniel D, Kurniawan A, Indah Pinawati AR, Thohira MC, Annaduzzaman M. The COVID-19 Health Protocol among University Students: Case Studies in Three Cities in Indonesia. Int J Environ Res Public Health 2022; 19:10630. [PMID: 36078346 PMCID: PMC9517742 DOI: 10.3390/ijerph191710630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has caused lifestyle changes for everyone and led to the practice of regulated health protocols for preventing the spreading or severity of the COVID-19 pandemic. This study examines the differences in health protocols and health practices among university students. The designed online survey was conducted among 292 university students in three cities in Indonesia, i.e., Yogyakarta, Semarang, and Surakarta. A forced-entry multivariate regression was conducted using all RANAS (risk, attitude, norms, ability-self-regulation) sub-factors as independent variables and health protocol obtained from PCA as the dependent variable. The results showed that the students' health protocol and health practices were practiced with varying frequency. A face mask covering the chin and nose was the most practiced health protocol, while reducing mobilization by maintaining distance was the most violated health protocol among students. We also found that four health protocol practices are highly correlated, i.e., handwashing in public spaces, physical distancing, frequency of using the mask, and avoiding crowded places. In addition, three significant psychological factors were identified, which were positively associated with the student's health protocol practice, i.e., belief about time (attitude) (OR: 0.119; CI: -0.054-0.136; p ≤ 0.05), personal norm (norm) (OR: 0.232; CI: 0.149-0.539; p ≤ 0.01), and action control (self-regulation) (OR: 0.173; CI: 0.046-0.427; p ≤ 0.05), where the personal norm is the most significant one. Finally, to minimize the COVID-19 transmission among students, especially when they back to onsite learning, it was important to create students' sense of ethical self-obligation to follow and practice standard health hygiene correctly and regularly.
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Affiliation(s)
- D. Daniel
- Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sleman 55281, Indonesia
| | - Arif Kurniawan
- Department of Environmental Science, The Graduate School, Universitas Gadjah Mada, Sleman 55281, Indonesia
| | | | | | - Md Annaduzzaman
- Sanitary Engineering Section, Faculty of Civil Engineering and Geosciences, Delft University of Technology, 2600 Delft, The Netherlands
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Ma E, Yu E, Szado T, Price R, Meyer CS, Shah A, Yang B, Vaena D, Daniel D, Slater D, Staszewski H, Fang B, Seneviratne L, Schwartzberg L. Abstract 2267: Biomarker testing and treatment (tx) patterns in a large community oncology network. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-2267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Biomarker testing identifies actionable mutations to inform targeted tx for personalized healthcare. This study examined biomarker testing and tx patterns ≤ 90 days (d) after advanced (adv) or metastatic (met) diagnosis (Dx) at the OneOncology (OneOnc) network.
Methods: A retrospective observational study using the nationwide Flatiron Health electronic health record-derived de-identified database from selected OneOnc practices included patients (pts) ≥ 18 y, who had Dx between 1/1/18 - 4/30/21 with adv non-small cell lung cancer (aNSCLC), met breast cancer (mBC), met colorectal cancer (mCRC) or adv melanoma (aMel), with ≥ 1 visit ≤ 90 d after adv or met Dx, and who had ≥ 90 d follow-up. Descriptive analyses were conducted.
Results: Of the pts who met the inclusion criteria, 91% of 2,391 aNSCLC, 100% of 1,043 mBC, 92% of 1,344 mCRC and 84% of 358 aMel had ≥ 1 biomarker test at any time, where 78% aNSCLC, 82% mBC, 70% mCRC and 67% aMel were tested ≤ 90 d after adv or met Dx. Testing rates varied by biomarker (Table). Across indications, ≥ 70% commercial health insured vs. ≥ 50% Medicaid insured pts were tested. Commercial labs were used in 91% aNSCLC, 86% mBC, 80% mCRC and 93% aMel. Amongst treated pts, 14% of 1,693 aNSCLC, 2% of 725 mBC, 22% of 881 mCRC and 25% of 169 aMel received tx before test results were available. NGS was tested in 69% aNSCLC, 29% mBC, 70% mCRC, and 57% aMel. The median turnaround time (TAT) from adv or met Dx to 1st test result from NGS vs other biomarker tests was 26 vs 13 d in aNSCLC, 14 vs 5 d in mBC, 35 vs 10 d in mCRC and 44 vs 21 d in aMel.
Conclusions: The majority of testing occurred ≤ 90 d after adv or met Dx, while 18% - 33% of pts were not tested. The varying testing rates across indications reflect the intended use of biomarker tests to guide 1st line therapies. More than 75% pts treated after testing result available signal community oncologist recognizing the importance of biomarker testing in guiding tx decisions. Improvements in TAT for NGS may reduce the issue of tx decisions made prior to test results.
Table. Biomarker testing rate by indication amongst pts tested ≤ 90 d after adv or met Dx aNSCLCn=1,858 mBCn=859 mCRCn=936 aMeln=239 EGFR 89% ALK 87% BRAF 81% 80% 98% KRAS 67% 82% ROS1 86% PD-L1 85% 18% 27% ER 93% PR 93% HER2 92% BRCA 20% PIK3CA 28% MMR/MSI 93% NRAS 77% 49% KIT 50% ER, estrogen receptor; MMR, mismatch repair; MSI, microsatellite instability; PR, progesterone receptor.
Citation Format: Esprit Ma, Elaine Yu, Tania Szado, Richard Price, Craig S. Meyer, Anuj Shah, Baiyu Yang, Daniel Vaena, Davey Daniel, Dennis Slater, Harry Staszewski, Bruno Fang, Lasika Seneviratne, Lee Schwartzberg. Biomarker testing and treatment (tx) patterns in a large community oncology network [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2267.
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Affiliation(s)
- Esprit Ma
- 1Genentech, Inc., South San Francisco, CA
| | - Elaine Yu
- 1Genentech, Inc., South San Francisco, CA
| | | | | | | | - Anuj Shah
- 1Genentech, Inc., South San Francisco, CA
| | | | - Daniel Vaena
- 3West Cancer Center & Research Institute, Germantown, TN
| | | | - Dennis Slater
- 5Eastern Connecticut Hematology and Oncology, Norwich, CT
| | - Harry Staszewski
- 6New York Cancer and Blood Specialists, Port Jefferson Station, NY
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Cascone T, García-Campelo R, Spicer J, Weder W, Daniel D, Spigel D, Hussein M, Mazieres J, Oliveira J, Yau E, Spira A, Mager R, Hamid O, Cheng LY, Zheng Y, Blando J, McGrath L, Grenga I, Soo-Hoo Y, Kumar R, Forde P. Abstract CT011: NeoCOAST: open-label, randomized, phase 2, multidrug platform study of neoadjuvant durvalumab alone or combined with novel agents in patients (pts) with resectable, early-stage non-small-cell lung cancer (NSCLC). Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-ct011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Neoadjuvant anti-PD-(L)1 therapy may offer clinical benefit in resectable, early-stage NSCLC. NeoCOAST (NCT03794544) is a global, randomized phase 2 study of the anti-PD-L1 monoclonal antibody (mAb) durvalumab (D) alone or combined with the anti-CD73 mAb oleclumab (O), the anti-NKG2A mAb monalizumab (M), or the anti-STAT3 antisense oligonucleotide danvatirsen (Da) as neoadjuvant therapy.
Methods: Pts with previously untreated, cytologically/histologically documented, resectable, Stage I [>2 cm]-IIIA NSCLC and ECOG PS 0-1 were randomized 1:1:1:1 (stratified by lymph node involvement) to receive D 1500 mg IV alone Q4W or combined with O 3000 mg IV Q2W, M 750 mg IV Q2W, or Da 200 mg IV QW, for one 28-day cycle, followed by surgery. Da monotherapy was also given on days 1, 3 and 5 of the week prior to combination treatment. The primary endpoint was investigator-assessed major pathological response (MPR; ≤10% residual viable tumor cells at tumor site and nodes, at surgery). Secondary endpoints were pathological complete response (pCR; no viable tumor cells), safety and tolerability, feasibility of surgery, PK and immunogenicity. Exploratory endpoints included tumor and microbiome biomarkers and blood mRNA signatures.
Results: From March 2019 to Sept 2020, 84 pts were randomized and 83 received D (n=26), D+O (n=21), D+M (n=20), or D+Da (n=16). MPR occurred in 11.1% (95% CI, 2.4-29.2), 19.0% (95% CI, 5.4-41.9), 30.0% (95% CI, 11.9-54.3), and 31.3% (95% CI, 11.0-58.7%), respectively. pCR occurred in 3.7% (95% CI, 0.1-19.0), 9.5% (95% CI, 1.2-30.4), 10.0% (95% CI, 1.2-31.7%) and 12.5% (95% CI, 1.6-38.3), respectively. Rates of treatment-related AEs were 34.6% with D, 57.1% with D+O, 50.0% with D+M, and 43.8% with D+Da (grade ≥3 in 0%, 4.8%, 0% and 6.3%, respectively). Most pts (76/83; 91.6%) completed surgery with no significant delay; of the 7 pts unable to, 5 had progressive or stage IV disease. Across all arms, MPR was more common in pts with baseline tumor PD-L1 expression ≥1% vs those with <1%. With D, CD73 expression was correlated with greater residual viable tumor cells at surgery; however, with D+O, high CD73 (≥10% tumor cells) was associated with reduced viable tumor cells. Transcriptome analysis of post-treatment and baseline blood samples showed upregulation of genes involved in B cell activation and antigen presentation in pts with MPR in the D+O arm, and upregulation of genes associated with Tregs in pts with MPR in the D+M arm.
Conclusions: One cycle of D + O, M or Da improved MPR and pCR rates vs D alone, with no new safety signals. Responses were associated with baseline tumor PD-L1 and CD73 expression levels. Pts with MPR receiving D+O or D+M had peripheral transcriptomic signatures related to immune cell function. These data warrant further investigation of these agents in resectable NSCLC.
Citation Format: Tina Cascone, Rosario García-Campelo, Jonathan Spicer, Walter Weder, Davey Daniel, David Spigel, Maen Hussein, Julien Mazieres, Julio Oliveira, Edwin Yau, Alexander Spira, Raymond Mager, Oday Hamid, Lin-Yang Cheng, Ying Zheng, Jorge Blando, Lara McGrath, Italia Grenga, Yee Soo-Hoo, Rakesh Kumar, Patrick Forde. NeoCOAST: open-label, randomized, phase 2, multidrug platform study of neoadjuvant durvalumab alone or combined with novel agents in patients (pts) with resectable, early-stage non-small-cell lung cancer (NSCLC) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT011.
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Affiliation(s)
- Tina Cascone
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Walter Weder
- 4University Hospital of Zurich, Zurich, Switzerland
| | - Davey Daniel
- 5Sarah Cannon Research Institute/Tennessee Oncology,, Nashville, TN
| | - David Spigel
- 6Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN
| | - Maen Hussein
- 7Sarah Cannon Research Institute, Florida Cancer Specialists, Leesburg, FL
| | - Julien Mazieres
- 8Thoracic Oncology Department, Toulouse University Hospital, Toulouse, France
| | - Julio Oliveira
- 9Medical Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil (IPO-PORTO), Porto, Portugal
| | - Edwin Yau
- 10Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Alexander Spira
- 11Virginia Cancer Specialists, US Oncology Research, NEXT Oncology Virginia, Fairfax, VA
| | | | | | | | | | | | | | | | | | | | - Patrick Forde
- 14Bloomberg–Kimmel Institute for Cancer Immunotherapy, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD
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Senan S, Özgüroğlu M, Daniel D, Villegas A, Vicente D, Murakami S, Hui R, Faivre-Finn C, Paz-Ares L, Wu YL, Mann H, Dennis PA, Antonia SJ. Outcomes with durvalumab after chemoradiotherapy in stage IIIA-N2 non-small-cell lung cancer: an exploratory analysis from the PACIFIC trial. ESMO Open 2022; 7:100410. [PMID: 35247871 PMCID: PMC9058904 DOI: 10.1016/j.esmoop.2022.100410] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/11/2022] [Accepted: 01/22/2022] [Indexed: 12/25/2022] Open
Abstract
Background The phase III PACIFIC trial (NCT02125461) established consolidation durvalumab as standard of care for patients with unresectable, stage III non-small-cell lung cancer (NSCLC) and no disease progression following chemoradiotherapy (CRT). In some cases, patients with stage IIIA-N2 NSCLC are considered operable, but the relative benefit of surgery is unclear. We report a post hoc, exploratory analysis of clinical outcomes in the PACIFIC trial, in patients with or without stage IIIA-N2 NSCLC. Materials and methods Patients with unresectable, stage III NSCLC and no disease progression after ≥2 cycles of platinum-based, concurrent CRT were randomized 2 : 1 to receive durvalumab (10 mg/kg intravenously; once every 2 weeks for up to 12 months) or placebo, 1-42 days after CRT. The primary endpoints were progression-free survival (PFS; assessed by blinded independent central review according to RECIST version 1.1) and overall survival (OS). Treatment effects within subgroups were estimated by hazard ratios (HRs) from unstratified Cox proportional hazards models. Results Of 713 randomized patients, 287 (40%) had stage IIIA-N2 disease. Baseline characteristics were similar between patients with and without stage IIIA-N2 NSCLC. With a median follow-up of 14.5 months (range: 0.2-29.9 months), PFS was improved with durvalumab versus placebo in both patients with [HR = 0.46; 95% confidence interval (CI), 0.33-0.65] and without (HR = 0.62; 95% CI 0.48-0.80) stage IIIA-N2 disease. Similarly, with a median follow-up of 25.2 months (range: 0.2-43.1 months), OS was improved with durvalumab versus placebo in patients with (HR = 0.56; 95% CI 0.39-0.79) or without (HR = 0.78; 95% CI 0.57-1.06) stage IIIA-N2 disease. Durvalumab had a manageable safety profile irrespective of stage IIIA-N2 status. Conclusions Consistent with the intent-to-treat population, treatment benefits with durvalumab were confirmed in patients with stage IIIA-N2, unresectable NSCLC. Prospective studies are needed to determine the optimal treatment approach for patients who are deemed operable. The PACIFIC trial established durvalumab after CRT as standard of care for unresectable, stage III NSCLC. The optimum multimodal treatment strategy for patients with potentially resectable, stage IIIA-N2 NSCLC is unknown. Survival benefit with durvalumab was observed in patients with stage IIIA-N2, unresectable NSCLC in this post hoc analysis. Durvalumab after CRT also exhibited a manageable safety profile in this subpopulation from PACIFIC. Studies of surgical vs. non-surgical strategies are needed to establish the best approach for potentially operable patients.
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Affiliation(s)
- S Senan
- Department of Radiation Oncology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.
| | - M Özgüroğlu
- Istanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - D Daniel
- Tennessee Oncology, Chattanooga, USA; Sarah Cannon Research Institute, Nashville, USA
| | - A Villegas
- Cancer Specialists of North Florida, Jacksonville, USA
| | - D Vicente
- Hospital Universitario Virgen Macarena, Seville, Spain
| | | | - R Hui
- Westmead Hospital and the University of Sydney, Sydney, Australia
| | - C Faivre-Finn
- The University of Manchester and The Christie NHS Foundation Trust, Manchester, UK
| | - L Paz-Ares
- Universidad Complutense, CiberOnc, CNIO and Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Y L Wu
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital & Guangdong Academy of Medical Sciences, Guangzhou, China
| | - H Mann
- AstraZeneca, Cambridge, UK
| | | | - S J Antonia
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
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Satriani S, Ilma IS, Daniel D. Trends of Water, Sanitation, and Hygiene (WASH) Research in Indonesia: A Systematic Review. IJERPH 2022; 19:ijerph19031617. [PMID: 35162638 PMCID: PMC8835571 DOI: 10.3390/ijerph19031617] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/24/2022] [Accepted: 01/28/2022] [Indexed: 02/05/2023]
Abstract
This study provides an overview of water, sanitation, and hygiene (WASH) research trends in Indonesia from 1975 until April 2021. The systematic review compiled 272 articles related to the Sustainable Development Goals 6.1 and 6.2 in Indonesia, which were published in the Web of Science and Scopus databases. The results showed that the water-related topic (41%) was discussed more often than sanitation (22%) or hygiene (13%). Furthermore, the social theme (39%) was dominantly found in all these articles, mostly finding determinants of WASH-related behavior. However, few WASH implementation studies or behavioral change interventions were recorded in Indonesia, suggesting a gap between science and policy or implementation. On the other hand, hygiene-related topics (14%) and WASH-related financial themes (6%) were the least studied in Indonesia. Combinations of topics (23%) and themes (15%) were also often conducted in Indonesia, suggesting that WASH researchers started to recognize the need to analyze WASH problems holistically, i.e., from multiple perspectives. In addition, the distribution of WASH research was still dominated in the central part of Indonesia, whereas the WASH-related problems, i.e., poor WASH services, and behavior, often occur in this area. This study also offers some research gaps, both in terms of topics, themes, and regional distribution, that need to be considered for the design of future WASH research in Indonesia.
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Affiliation(s)
- S. Satriani
- Department of Environmental Science, The Graduate School, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia; (S.S.); (I.S.I.)
| | - Izana Saffana Ilma
- Department of Environmental Science, The Graduate School, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia; (S.S.); (I.S.I.)
| | - D. Daniel
- Department of Water Management, Faculty of Civil Engineering and Geosciences, Delft University of Technology, 2628 CN Delft, The Netherlands
- Department of Health Behaviour, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
- Correspondence: or
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Sadhana S, Pandiarajan S, Sivaraman E, Daniel D. AI-based Power Screening Solution for SARS-CoV2 Infection: A Sociodemographic Survey and COVID-19 Cough Detector. Procedia Comput Sci 2021; 194:255-271. [PMID: 34876935 PMCID: PMC8641370 DOI: 10.1016/j.procs.2021.10.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Globally, the confirmed coronavirus (SARS-CoV2) cases are being increasing day by day. Coronavirus (COVID-19) causes an acute infection in the respiratory tract that started spreading in late 2019. Huge datasets of SARS-CoV2 patients can be incorporated and analyzed by machine learning strategies for understanding the pattern of pathological spread and helps to analyze the accuracy and speed of novel therapeutic methodologies, also detect the susceptible people depends on their physiological and genetic aspects. To identify the possible cases faster and rapidly, we propose the Artificial Intelligence (AI) power screening solution for SARS- CoV2 infection that can be deployable through the mobile application. It collects the details of the travel history, symptoms, common signs, gender, age and diagnosis of the cough sound. To examine the sharpness of pathomorphological variations in respiratory tracts induced by SARS-CoV2, that compared to other respiratory illnesses to address this issue. To overcome the shortage of SARS-CoV2 datasets, we apply the transfer learning technique. Multipronged mediator for risk-averse Artificial Intelligence Architecture is induced for minimizing the false diagnosis of risk-stemming from the problem of complex dimensionality. This proposed application provides early detection and prior screening for SARS-CoV2 cases. Huge data points can be processed through AI framework that can examine the users and classify them into "Probably COVID", "Probably not COVID" and "Result indeterminate".
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Affiliation(s)
- S Sadhana
- Department of CSE, Kalaignarkarunanidhi Institute of Technology, Coimbatore, India
| | - S Pandiarajan
- Department of CSE, Kalaignarkarunanidhi Institute of Technology, Coimbatore, India
| | - E Sivaraman
- Department of CSE, PES University, Bangalore, India
| | - D Daniel
- Department of CSE, Christ (Deemed to be University), Bangalore, India
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Vanderwalde A, Lu M, Maund S, Huntley M, Incerti D, Fine A, Tolba K, Jin D, Bourla A, Sondhi A, Tromanhauser M, Daniel D, Tilford J, Mcfarlane J, Lakhanpal S, Oxnard G, Schulze K. P10.14 ctDNA and Real-World Response (rwR) in Patients With Lung Cancer From A Prospective Real-World Clinico-Genomic (PCG) Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Daniel D, Djohan D, Machairas I, Pande S, Arifin A, Al Djono TP, Rietveld L. Financial, institutional, environmental, technical, and social (FIETS) aspects of water, sanitation, and hygiene conditions in indigenous - rural Indonesia. BMC Public Health 2021; 21:1723. [PMID: 34551739 PMCID: PMC8459497 DOI: 10.1186/s12889-021-11800-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 09/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background There is increasing recognition of the complexity underlying WASH conditions in developing countries. This article explores the complexity by assessing the vulnerability of a specific area to poor WASH conditions using a qualitative approach. Methods We present our findings for the district of East Sumba in Indonesia. This area is known as one of the poorest regions in Indonesia with inadequate WASH services, indigenous belief that hinder the practice of WASH-related behaviours, and has a high rate of children malnutrition. All the factors that contribute to poor WASH conditions were discussed through the lens of the Financial, Institutional, Environmental, Technological, and Social (FIETS) framework. We then summarised the factors and visualized the “system” using a mind map which shows how factors are interconnected and helps to find the root causes of poor WASH conditions. Results There are three main challenges that inhibit the improvement of WASH conditions in this area: inadequate institutional capacity, water scarcity, and poor socio-economic conditions. We found that a village leader is the most important actor who influences the sustainability of WASH services in this area and healthcare workers are influential WASH promoters. This study also shows how culture shapes people’s daily lives and institution performance, and influences the current WASH conditions in East Sumba. The mind map shows there is an overlap and interconnection between FIEST aspects and WASH conditions in the study area. Conclusion WASH conditions are influenced by many factors and are often interconnected with each other. Understanding this complexity is necessary to improve WASH conditions and sustain adequate WASH services in developing countries. Finally, WASH interventions have to be considerate of the prevailing cultural practices and should involve multidisciplinary stakeholders. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11800-x.
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Affiliation(s)
- D Daniel
- Department of Water Management, Faculty of Civil Engineering and Geosciences, Delft University of Technology, Delft, the Netherlands. .,Department of Health Behaviour, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Dennis Djohan
- Department of Environmental Engineering, Faculty of Civil Engineering and Geosciences, Delft University of Technology, Delft, the Netherlands
| | - Ilias Machairas
- Department of Water Management, Faculty of Civil Engineering and Geosciences, Delft University of Technology, Delft, the Netherlands
| | - Saket Pande
- Department of Water Management, Faculty of Civil Engineering and Geosciences, Delft University of Technology, Delft, the Netherlands
| | - Arifin Arifin
- Department of Groundwater Engineering, Faculty of Earth Sciences and Technology, Bandung Institute of Technology, Bandung, Indonesia
| | - Trimo Pamudji Al Djono
- Department of Environmental Engineering, Sekolah Tinggi Teknologi Sapta Taruna, Jakarta, Indonesia
| | - Luuk Rietveld
- Department of Water Management, Faculty of Civil Engineering and Geosciences, Delft University of Technology, Delft, the Netherlands
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Daniel D, Kuchava V, Bondarenko I, Ivashchuk O, Reddy S, Jaal J, Kudaba I, Hart L, Matitashvili A, Pritchett Y, Morris SR, Sorrentino JA, Antal JM, Goldschmidt J. Trilaciclib prior to chemotherapy and atezolizumab in patients with newly diagnosed extensive-stage small cell lung cancer: A multicentre, randomised, double-blind, placebo-controlled Phase II trial. Int J Cancer 2021; 148:2557-2570. [PMID: 33348420 PMCID: PMC8048941 DOI: 10.1002/ijc.33453] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/16/2020] [Accepted: 11/25/2020] [Indexed: 12/15/2022]
Abstract
Trilaciclib is an intravenous CDK4/6 inhibitor administered prior to chemotherapy to preserve haematopoietic stem and progenitor cells and immune system function from chemotherapy-induced damage (myelopreservation). The effects of administering trilaciclib prior to carboplatin, etoposide and atezolizumab (E/P/A) were evaluated in a randomised, double-blind, placebo-controlled Phase II study in patients with newly diagnosed extensive-stage small cell lung cancer (ES-SCLC) (NCT03041311). The primary endpoints were duration of severe neutropenia (SN; defined as absolute neutrophil count <0.5 × 109 cells per L) in Cycle 1 and occurrence of SN during the treatment period. Other endpoints were prespecified to assess the effects of trilaciclib on additional measures of myelopreservation, patient-reported outcomes, antitumour efficacy and safety. Fifty-two patients received trilaciclib prior to E/P/A and 53 patients received placebo. Compared to placebo, administration of trilaciclib resulted in statistically significant decreases in the mean duration of SN in Cycle 1 (0 vs 4 days; P < .0001) and occurrence of SN (1.9% vs 49.1%; P < .0001), with additional improvements in red blood cell and platelet measures and health-related quality of life (HRQoL). Trilaciclib was well tolerated, with fewer grade ≥3 adverse events compared with placebo, primarily due to less high-grade haematological toxicity. Antitumour efficacy outcomes were comparable. Administration of trilaciclib vs placebo generated more newly expanded peripheral T-cell clones (P = .019), with significantly greater expansion among patients with an antitumour response to E/P/A (P = .002). Compared with placebo, trilaciclib administered prior to E/P/A improved patients' experience of receiving treatment for ES-SCLC, as shown by reduced myelosuppression, and improved HRQoL and safety profiles.
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Affiliation(s)
- Davey Daniel
- Sarah Cannon Research Institute, Tennessee Oncology‐ChattanoogaChattanoogaTennesseeUSA
| | | | | | | | | | - Jana Jaal
- Department of Hematology‐OncologyUniversity of TartuTartuEstonia
| | - Iveta Kudaba
- Latvian Oncology CentreRiga East University HospitalRigaLatvia
| | - Lowell Hart
- Florida Cancer SpecialistsFort MyersFloridaUSA
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Weiss J, Goldschmidt J, Andric Z, Dragnev KH, Gwaltney C, Skaltsa K, Pritchett Y, Antal JM, Morris SR, Daniel D. Effects of Trilaciclib on Chemotherapy-Induced Myelosuppression and Patient-Reported Outcomes in Patients with Extensive-Stage Small Cell Lung Cancer: Pooled Results from Three Phase II Randomized, Double-Blind, Placebo-Controlled Studies. Clin Lung Cancer 2021; 22:449-460. [PMID: 33895103 DOI: 10.1016/j.cllc.2021.03.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/01/2021] [Accepted: 03/18/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Chemotherapy-induced myelosuppression (CIM) and its sequalae cause significant side effects and harm to quality of life. Trilaciclib is an intravenous CDK4/6 inhibitor that is administered prior to chemotherapy to protect hematopoietic stem and progenitor cells from chemotherapy-induced damage (myeloprotection). PATIENTS AND METHODS Data from three randomized, double-blind, placebo-controlled studies (NCT02499770, NCT03041311, and NCT02514447) were pooled to evaluate the effects of trilaciclib administered prior to standard-of-care chemotherapy (first-line etoposide plus carboplatin [E/P], first-line E/P plus atezolizumab, and second-/third-line topotecan) in patients with extensive-stage small cell lung cancer (ES-SCLC). The primary endpoints were duration of severe neutropenia (absolute neutrophil count < 0.5 × 109 cells/L) in cycle 1 and occurrence of severe neutropenia. Additional prespecified endpoints further assessed the effect of trilaciclib on myeloprotection, health-related quality of life (HRQoL), antitumor efficacy, and safety. RESULTS Of 242 randomized patients, 123 received trilaciclib and 119 received placebo. Compared with placebo, administration of trilaciclib prior to chemotherapy resulted in significant decreases in most measures of multilineage CIM. The reduction in hematologic toxicity translated into the reduced need for supportive care interventions and hospitalizations due to CIM or sepsis and improvements in HRQoL domains related to the protected cell lineages, including fatigue, physical wellbeing, and functional wellbeing. Antitumor efficacy was similar for patients receiving trilaciclib or placebo. CONCLUSION Administering trilaciclib prior to chemotherapy resulted in clinically meaningful reductions in CIM and its consequences and improved patient HRQoL, with no impact on the antitumor efficacy of three individual chemotherapy regimens used in the first- or second-/third-line treatment of ES-SCLC.
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Affiliation(s)
- Jared Weiss
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
| | | | - Zoran Andric
- University Hospital Medical Center Bezanijska Kosa, Bezanijska Kosa, Belgrade, Serbia
| | | | | | | | | | | | | | - Davey Daniel
- Sarah Cannon Research Institute, Nashville, TN; Chattanooga Oncology Hematology Associates, Chattanooga, TN
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Garassino MC, Paz-Ares L, Hui R, Faivre-Finn C, Spira A, Planchard D, Özgüroğlu M, Daniel D, Vicente D, Murakami S, Langer C, Senan S, Spigel D, Rydén A, Zhang Y, O'Brien C, Dennis PA, Antonia SJ. Patient-reported outcomes with durvalumab by PD-L1 expression and prior chemoradiotherapy-related variables in unresectable stage III non-small-cell lung cancer. Future Oncol 2021; 17:1165-1184. [PMID: 33583206 DOI: 10.2217/fon-2020-1102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aim: We retrospectively investigated the impact of tumor PD-L1 expression and prior chemoradiotherapy (CRT)-related variables on patient-reported outcomes (PROs) from PACIFIC. Patients & methods: PACIFIC was a Phase III study of durvalumab versus placebo after CRT in patients with unresectable, stage III non-small-cell lung cancer. If available, pre-CRT tumor tissue was tested for PD-L1 tumor-cell expression, scored at prespecified (25%) and post-hoc (1%) cut-offs. PROs were assessed using EORTC QLQ C30/-LC13. Results: Similar to the intent-to-treat (ITT) population, most PROs remained stable over time across PD-L1 and CRT subgroups, with few clinically relevant differences between treatment arms. Time to deterioration was generally similar to the ITT population. Conclusion: Neither PD-L1 expression nor prior CRT-related variables influenced PROs with durvalumab therapy. Clinical trial registration: NCT02125461 (ClinicalTrials.gov).
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Affiliation(s)
| | - Luis Paz-Ares
- Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense & CNIO, Madrid, 28041, Spain
| | - Rina Hui
- Westmead Hospital & the University of Sydney, Sydney, NSW, 2145, Australia
| | - Corinne Faivre-Finn
- The University of Manchester & The Christie NHS Foundation Trust, Manchester, M20 4BX, UK
| | - Alex Spira
- Virginia Cancer Specialists Research Institute, Fairfax, VA, & US Oncology Research, The Woodlands, TX 22031, USA
| | - David Planchard
- Institut Gustave Roussy, Department of Medical Oncology, Thoracic Group, Villejuif, 94805, France
| | - Mustafa Özgüroğlu
- Istanbul University - Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, 34320, Turkey
| | - Davey Daniel
- Sarah Cannon Research Institute/Tennessee Oncology, Chattanooga, TN 37203, USA
| | - David Vicente
- Hospital Universitario Virgen Macarena, Seville, 41009, Spain
| | | | - Corey Langer
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Suresh Senan
- Department of Radiation Oncology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, 1081, The Netherlands
| | - David Spigel
- Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN 3720231, USA
| | | | | | | | | | - Scott J Antonia
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
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Faivre-Finn C, Spigel DR, Senan S, Langer C, Perez BA, Özgüroğlu M, Daniel D, Villegas A, Vicente D, Hui R, Murakami S, Paz-Ares L, Broadhurst H, Wadsworth C, Dennis PA, Antonia SJ. Impact of prior chemoradiotherapy-related variables on outcomes with durvalumab in unresectable Stage III NSCLC (PACIFIC). Lung Cancer 2020; 151:30-38. [PMID: 33285469 DOI: 10.1016/j.lungcan.2020.11.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/29/2020] [Accepted: 11/23/2020] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The PACIFIC trial demonstrated that durvalumab significantly improved progression-free and overall survival (PFS/OS), versus placebo, in patients with Stage III NSCLC and stable or responding disease following concurrent, platinum-based chemoradiotherapy (CRT). A range of CT and RT regimens were permitted, and used, in the trial. We report post-hoc, exploratory analyses of clinical outcomes from PACIFIC according to CRT-related variables. METHODS Patients were randomized 2:1 (1-42 days post-CRT) to up to 12 months durvalumab (10 mg/kg intravenously every 2 weeks) or placebo. Efficacy and safety were analyzed in patient subgroups defined by the following baseline variables: platinum-based CT (cisplatin/carboplatin); vinorelbine, etoposide, or taxane-based CT (all yes/no); total RT dose (<60 Gy/60-66 Gy/>66 Gy); time from last RT dose to randomization (<14 days/≥14 days); and use of pre-CRT induction CT (yes/no). Treatment effects for time-to-event endpoints were estimated by hazard ratios (HRs) from unstratified Cox-proportional-hazards models. RESULTS Overall, 713 patients were randomized, of whom 709 received treatment in either the durvalumab (n/N = 473/476) or placebo arms (n/N = 236/237). Durvalumab improved PFS, versus placebo, across all subgroups (median follow up, 14.5 months; HR range, 0.34-0.63). Durvalumab improved OS across most subgroups (median follow up, 25.2 months; HR range, 0.35-0.86); however, the 95 % confidence interval (CI) of the estimated treatment effect crossed one for the subgroups of patients who received induction CT (HR, 0.78 [95 % CI, 0.51-1.20]); carboplatin (0.86 [0.60-1.23]); vinorelbine (0.79 [0.49-1.27]); and taxane-based CT (0.73 [0.51-1.04]); and patients who were randomized ≥14 days post-RT (0.81 [0.62-1.06]). Safety was broadly similar across the CRT subgroups. CONCLUSION Durvalumab prolonged PFS and OS irrespective of treatment variables related to prior CRT to which patients with Stage III NSCLC had previously stabilized or responded. Limited patient numbers and imbalances in baseline factors in each subgroup preclude robust conclusions.
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Affiliation(s)
- Corinne Faivre-Finn
- The University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK.
| | - David R Spigel
- Tennessee Oncology, Chattanooga, TN, USA; Sarah Cannon Research Institute, Nashville, TN, USA
| | - Suresh Senan
- Department of Radiation Oncology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Corey Langer
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Bradford A Perez
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Mustafa Özgüroğlu
- Istanbul University - Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - Davey Daniel
- Tennessee Oncology, Chattanooga, TN, USA; Sarah Cannon Research Institute, Nashville, TN, USA
| | | | - David Vicente
- Hospital Universitario Virgen Macarena, Seville, Spain
| | - Rina Hui
- Westmead Hospital and the University of Sydney, Sydney, NSW, Australia
| | | | - Luis Paz-Ares
- Hospital Universitario 12 de Octubre, Lung Cancer Unit CNIO-H12o, CiberOnc and Universidad Complutense, Madrid, Spain
| | | | | | | | - Scott J Antonia
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Daniel D, Sirait M, Pande S. A hierarchical Bayesian Belief Network model of household water treatment behaviour in a suburban area: A case study of Palu-Indonesia. PLoS One 2020; 15:e0241904. [PMID: 33156850 PMCID: PMC7647107 DOI: 10.1371/journal.pone.0241904] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 10/22/2020] [Indexed: 11/21/2022] Open
Abstract
Understanding the determinants of household water treatment (HWT) behavior in developing countries is important to increase the rate of its regular use so that households can have safe water at home. This is especially so when the quality of the water source is not reliable. We present a hierarchical Bayesian Belief Network (BBN) model supported by statistical analysis to explore the influence of household’s socio-economic characteristics (SECs) on the HWT behavior via household’s psychological factors. The model uses eight SECs, such as mother’s and father’s education, wealth, and religion, and five RANAS psychological factors, i.e., risk, attitude, norms, ability, and self-regulation to analyse HWT behavior in a suburban area in Palu, Indonesia. Structured household interviews were conducted among 202 households. We found that mother’s education is the most important SEC that influences the regular use of HWT. An educated mother has more positive attitude towards HWT and is more confident in her ability to perform HWT. Moreover, self-regulation, especially the attempt to deal with any barrier that hinders HWT practice, is the most important psychological factor that can change irregular HWT users to regular HWT users. Hence, this paper recommends to HWT-program implementers to identify potential barriers and discuss potential solutions with the target group in order to increase the probability of the target group being a regular HWT user.
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Affiliation(s)
- D. Daniel
- Department of Water Management, Delft University of Technology, Delft, The Netherlands
- * E-mail:
| | - Mita Sirait
- Department of Ministry Quality and Impact, Health Units, Wahana Visi Indonesia, Tangerang Selatan, Indonesia
| | - Saket Pande
- Department of Water Management, Delft University of Technology, Delft, The Netherlands
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Daniel D, Iswarani WP, Pande S, Rietveld L. A Bayesian Belief Network model to link sanitary inspection data to drinking water quality in a medium resource setting in rural Indonesia. Sci Rep 2020; 10:18867. [PMID: 33139766 PMCID: PMC7606607 DOI: 10.1038/s41598-020-75827-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/16/2020] [Indexed: 11/12/2022] Open
Abstract
Assessing water quality and identifying the potential source of contamination, by Sanitary inspections (SI), are essential to improve household drinking water quality. However, no study link the water quality at a point of use (POU), household level or point of collection (POC), and associated SI data in a medium resource setting using a Bayesian Belief Network (BBN) model. We collected water samples and applied an adapted SI at 328 POU and 265 related POC from a rural area in East Sumba, Indonesia. Fecal contamination was detected in 24.4 and 17.7% of 1 ml POC and POU samples, respectively. The BBN model showed that the effect of holistic—combined interventions to improve the water quality were larger compared to individual intervention. The water quality at the POU was strongly related to the water quality at the POC and the effect of household water treatment to improve the water quality was more prominent in the context of better sanitation and hygiene conditions. In addition, it was concluded that the inclusion of extra “external” variable (fullness level of water at storage), besides the standard SI variables, could improve the model’s performance in predicting the water quality at POU. Finally, the BBN approach proved to be able to illustrate the interdependencies between variables and to simulate the effect of the individual and combination of variables on the water quality.
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Affiliation(s)
- D Daniel
- Department of Water Management, Delft University of Technology, Delft, The Netherlands.
| | | | - Saket Pande
- Department of Water Management, Delft University of Technology, Delft, The Netherlands
| | - Luuk Rietveld
- Department of Water Management, Delft University of Technology, Delft, The Netherlands
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Daniel D, Zuretti A. Incidental Prostate Infections: Developing the Prostate Microbiome. Am J Clin Pathol 2020. [DOI: 10.1093/ajcp/aqaa161.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction/Objective
About 1 in 9 men will be diagnosed with prostate cancer in their lifetime. The traditional method of diagnosis is via a 12 core, trans-rectal biopsy. While this has been an appropriate method of investigation, a rectal approach to the prostate core made it difficult to differentiate prostatic bacterial infection from fecal contamination. Utilizing a sterile trans-perineal approach for biopsy, we were able to establish a true microbiome of the prostate, without contamination.
Methods
This is a prospective, IRB approved study. Men who were required to have prostate biopsies were offered a trans-perineal or trans rectal method of biopsy. Those who opted for trans-perineal biopsy with a negative urine culture met the inclusion criteria. Urine culture was performed prior to scheduling for the procedure. At time of biopsy, sterile cultures were taken from the rectum and one randomly selected prostate core. Cultures were grown for 5 days, and the results were recorded.
Results
Of the 93 patients who met inclusion criteria, eight men contained various bacteria within the sterilely accessed prostate core. Of the eight prostate cores which grew positive cultures, five of those patients had an isolated prostatic infection, without rectal or urinary co-infection. The most common infections included E. coli (n=2) and Klebsiella species (n=3).
Conclusion
New techniques in the performance of prostate biopsy provides the microbiology laboratory unique opportunities for investigation. This is the beginning of the study of the prostate microbiome, and future correlation with prostate cancer and isolated prostate infection are areas of future inquiry.
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Affiliation(s)
- D Daniel
- Pathology, Maimonides Medical Center, Brooklyn, New York, UNITED STATES
| | - A Zuretti
- Pathology, Maimonides Medical Center, Brooklyn, New York, UNITED STATES
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Planchard D, Özgüroğlu M, Daniel D, Villegas A, Vicente D, Murakami S, Hui R, Faivre-Finn C, Paz-Ares L, Wu YL, Macpherson E, Newton M, Dennis P, Antonia SJ. Abstract CT213: Impact of smoking on outcomes with durvalumab following chemoradiotherapy in unresectable Stage III NSCLC (PACIFIC). Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-ct213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The phase 3 PACIFIC trial established durvalumab (durva) after concurrent chemoradiotherapy (cCRT) as standard of care for unresectable Stage III NSCLC. We report exploratory, post-hoc analyses to assess the impact of smoking status on outcomes in pts from PACIFIC.
Methods: PACIFIC was a double-blind trial of pts without disease progression after platinum-based cCRT (≥2 cycles). Pts were randomized 2:1 to receive durva 10 mg/kg or placebo (pbo) intravenously q2w for ≤12 months, stratified by age, sex, and smoking history. Primary endpoints were PFS and OS. Treatment effects (HRs) within subgroups of smokers (current and former) and never smokers were estimated from unstratified Cox proportional hazards models (Kaplan-Meier-estimated medians).
Results: Of 713 randomized pts, 64 (9%) were never smokers (Table). Baseline characteristics were broadly well balanced; however, irrespective of study arm, proportionally more never smokers (vs smokers) were female, Asian, and had non-squamous histology. Among never smokers, proportionally more pts in the pbo arm vs durva arm were Stage IIIB (52% vs 40%) and had received induction chemotherapy (33% vs 21%). PFS and OS were improved with durva vs pbo in both smokers and never smokers (Table). The incidence of grade 3/4 AEs was proportionally higher in smokers (vs never smokers) in both the durva (34% vs 23%) and pbo arms (30% vs 14%). In contrast, the incidence of any-grade pneumonitis/radiation pneumonitis was proportionally higher in never smokers (vs smokers) in the durva (56% vs 32% [grade 3/4: 7% vs 3%]) and pbo arms (48% vs 23% [grade 3/4: 5% vs 2%]).
SmokersNever SmokersDurvalumab (n=433)Placebo (n=216)Durvalumab(n=43)Placebo(n=21)# of PFS events (%)197 (45.5)140 (64.8)17 (39.5)17 (81.0)PFS HR (95% CI)0.59 (0.47-0.73)0.29 (0.15-0.57)Median PFS (95% CI), mo16.8 (12.3-17.8)6.4 (4.9-8.7)NR (7.2-NE)3.0 (1.8-5.6)12-mo PFS (95% CI), %55.7 (50.6-60.5)37.5 (30.8-44.2)57.8 (40.8-71.5)8.4 (0.6-29.9)18-mo PFS (95% CI), %43.1 (36.2-49.7)28.4 (20.9-36.4)57.8 (40.8-71.5)NR (NE-NE)*# of OS events (%)169 (39.0)103 (47.7)14 (32.6)13 (61.9)OS HR (95% CI)0.72 (0.56-0.92)0.35 (0.16-0.76)Median OS (95% CI), moNR (33.2-NR)29.1 (23.5-NR)34.9 (28.3-NR)18.7 (12.5-31.0)12-mo OS (95% CI), %82.8 (78.9-86.1)75.3 (68.9-80.6)86.0 (71.6-93.5)75.4 (50.6-89.0)24-mo OS (95% CI), %65.5 (60.7-69.8)56.7 (49.7-63.2)74.1 (58.0-84.7)43.1 (21.1-63.4)*Kaplan-Meier undefined; no patients at risk at 18 mo.PFS was assessed by blinded independent central review (RECIST v1.1).Median follow up for PFS = 14.5 mo (DCO for the primary analysis of PFS: 13 Feb 2017).Median follow up for OS = 25.2 mo (DCO for the primary analysis of OS: 22 Mar 2018).CI, confidence interval; DCO, data cutoff; HR, hazard ratio; mo, months; NR, not reached; NE, not estimable; OS, overall survival; PFS, progression-free survival.
Conclusions: Consistent with the ITT population, durva improved PFS and OS in both smokers and never smokers with unresectable Stage III NSCLC who had received prior cCRT. The small size of the never smokers subgroup and imbalances in baseline characteristics preclude robust conclusions regarding inter-subgroup differences in clinical outcomes.
Citation Format: David Planchard, Mustafa Özgüroğlu, Davey Daniel, Augusto Villegas, David Vicente, Shuji Murakami, Rina Hui, Corinne Faivre-Finn, Luis Paz-Ares, Yi-Long Wu, Euan Macpherson, Michael Newton, Phillip Dennis, Scott J. Antonia. Impact of smoking on outcomes with durvalumab following chemoradiotherapy in unresectable Stage III NSCLC (PACIFIC) [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr CT213.
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Affiliation(s)
- David Planchard
- 1Gustave Roussy, Department of Medical Oncology, Thoracic Unit, Villejuif, France
| | - Mustafa Özgüroğlu
- 2Istanbul University − Cerrahpaşa, Cerrahpaşa School of Medicine, Cerrahpaşa, Turkey
| | - Davey Daniel
- 3Tennessee Oncology, Chattanooga, TN, and Sarah Cannon Research Institute, Nashville, TN
| | | | - David Vicente
- 5Department of Clinical Oncology, H.U.V. Macarena, Seville, Spain
| | | | - Rina Hui
- 7Westmead Hospital and the University of Sydney, Sydney, Australia
| | - Corinne Faivre-Finn
- 8The University of Manchester and The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Luis Paz-Ares
- 9Hospital Universitario 12 de Octubre, Lung Cancer Unit CNIO-H12o, CiberOnc and Universidad Complutense, Madrid, Spain
| | - Yi-Long Wu
- 10Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital & Guangdong Academy of Medical Science, Guangzhou, China
| | | | | | | | - Scott J. Antonia
- 13H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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Olvera D, Daniel D. Benefits of positive pressure ventilation for preoxygenation before rapid sequence intubation are dependent upon oxygenation status. Br J Anaesth 2020. [DOI: 10.1016/j.bja.2020.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Paz-Ares L, Spira A, Raben D, Planchard D, Cho BC, Özgüroğlu M, Daniel D, Villegas A, Vicente D, Hui R, Murakami S, Spigel D, Senan S, Langer CJ, Perez BA, Boothman AM, Broadhurst H, Wadsworth C, Dennis PA, Antonia SJ, Faivre-Finn C. Outcomes with durvalumab by tumour PD-L1 expression in unresectable, stage III non-small-cell lung cancer in the PACIFIC trial. Ann Oncol 2020; 31:798-806. [PMID: 32209338 DOI: 10.1016/j.annonc.2020.03.287] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/14/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In the PACIFIC trial, durvalumab significantly improved progression-free and overall survival (PFS/OS) versus placebo, with manageable safety, in unresectable, stage III non-small-cell lung cancer (NSCLC) patients without progression after chemoradiotherapy (CRT). We report exploratory analyses of outcomes by tumour cell (TC) programmed death-ligand 1 (PD-L1) expression. PATIENTS AND METHODS Patients were randomly assigned (2:1) to intravenous durvalumab 10 mg/kg every 2 weeks or placebo ≤12 months, stratified by age, sex, and smoking history, but not PD-L1 status. Where available, pre-CRT samples were tested for PD-L1 expression (immunohistochemistry) and scored at pre-specified (25%) and post hoc (1%) TC cut-offs. Treatment-effect hazard ratios (HRs) were estimated from unstratified Cox proportional hazards models (Kaplan-Meier-estimated medians). RESULTS In total, 713 patients were randomly assigned, 709 of whom received at least 1 dose of study treatment durvalumab (n = 473) or placebo (n = 236). Some 451 (63%) were PD-L1-assessable: 35%, 65%, 67%, 33%, and 32% had TC ≥25%, <25%, ≥1%, <1%, and 1%-24%, respectively. As of 31 January 2019, median follow-up was 33.3 months. Durvalumab improved PFS versus placebo (primary-analysis data cut-off, 13 February 2017) across all subgroups [HR, 95% confidence interval (CI); medians]: TC ≥25% (0.41, 0.26-0.65; 17.8 versus 3.7 months), <25% (0.59, 0.43-0.82; 16.9 versus 6.9 months), ≥1% (0.46, 0.33-0.64; 17.8 versus 5.6 months), <1% (0.73, 0.48-1.11; 10.7 versus 5.6 months), 1%-24% [0.49, 0.30-0.80; not reached (NR) versus 9.0 months], and unknown (0.59, 0.42-0.83; 14.0 versus 6.4 months). Durvalumab improved OS across most subgroups (31 January 2019 data cut-off; HR, 95% CI; medians): TC ≥ 25% (0.50, 0.30-0.83; NR versus 21.1 months), <25% (0.89, 0.63-1.25; 39.7 versus 37.4 months), ≥1% (0.59, 0.41-0.83; NR versus 29.6 months), 1%-24% (0.67, 0.41-1.10; 43.3 versus 30.5 months), and unknown (0.60, 0.43-0.84; 44.2 versus 23.5 months), but not <1% (1.14, 0.71-1.84; 33.1 versus 45.6 months). Safety was similar across subgroups. CONCLUSIONS PFS benefit with durvalumab was observed across all subgroups, and OS benefit across all but TC <1%, for which limitations and wide HR CI preclude robust conclusions.
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Affiliation(s)
- L Paz-Ares
- Hospital Universitario 12 de Octubre, Lung Cancer Unit CNIO-H12o, CiberOnc and Universidad Complutense, Madrid, Spain.
| | - A Spira
- Virginia Health Specialists, Fairfax, USA
| | - D Raben
- Department of Radiation Oncology, University of Colorado Denver, Aurora, USA
| | - D Planchard
- Gustave Roussy, Department of Medical Oncology, Thoracic Unit, Villejuif, France
| | - B C Cho
- Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - M Özgüroğlu
- Istanbul University - Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - D Daniel
- Tennessee Oncology, Chattanooga and Sarah Cannon Research Institute, Nashville, USA
| | - A Villegas
- Cancer Specialists of North Florida, Jacksonville, USA
| | - D Vicente
- Department of Clinical Oncology, H.U.V. Macarena, Seville, Spain
| | - R Hui
- Westmead Hospital and University of Sydney, Sydney, Australia
| | | | - D Spigel
- Tennessee Oncology, Chattanooga and Sarah Cannon Research Institute, Nashville, USA
| | - S Senan
- Department of Radiation Oncology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - C J Langer
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA
| | - B A Perez
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | | | | | | | | | - S J Antonia
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | - C Faivre-Finn
- The University of Manchester and The Christie NHS Foundation Trust, Manchester, UK
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Chiramel MJ, George R, Daniel D, Sam Arul Das R, Mani V, Antonisamy B, Muliyil JP. Case-control study measuring the association between HLA-B*13:01 and dapsone hypersensitivity syndrome in Indian patients. LEPROSY REV 2019. [DOI: 10.47276/lr.90.4.371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gray JE, Villegas A, Daniel D, Vicente D, Murakami S, Hui R, Kurata T, Chiappori A, Lee KH, Cho BC, Planchard D, Paz-Ares L, Faivre-Finn C, Vansteenkiste JF, Spigel DR, Wadsworth C, Taboada M, Dennis PA, Özgüroğlu M, Antonia SJ. Three-Year Overall Survival with Durvalumab after Chemoradiotherapy in Stage III NSCLC-Update from PACIFIC. J Thorac Oncol 2019; 15:288-293. [PMID: 31622733 PMCID: PMC7244187 DOI: 10.1016/j.jtho.2019.10.002] [Citation(s) in RCA: 277] [Impact Index Per Article: 55.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/24/2019] [Accepted: 10/02/2019] [Indexed: 12/24/2022]
Abstract
Introduction: In the phase 3 PACIFIC study of patients with unresectable stage III NSCLC without progression after chemoradiotherapy, durvalumab demonstrated significant improvements versus placebo in the primary end points of progression-free survival (hazard ratio [HR] = 0.52, 95% confidence interval [CI]: 0.42–65, p < 0.0001) and overall survival (OS) (HR = 0.68, 95% CI: 0.53–0.87, p = 0.00251), with manageable safety and no detrimental effect on patient-reported outcomes. Here, we report 3-year OS rates for all patients randomized in the PACIFIC study. Methods: Patients, stratified by age, sex, and smoking history, were randomized (2:1) to receive durvalumab, 10 mg/kg intravenously every 2 weeks, or placebo for up to 12 months. OS was analyzed by using a stratified log-rank test in the intention-to-treat population. Medians and rates at 12, 24, and 36 months were estimated by the Kaplan-Meier method. Results: As of January 31, 2019, 48.2% of patients had died (44.1% and 56.5% in the durvalumab and placebo groups, respectively). The median duration of follow-up was 33.3 months. The updated OS remained consistent with that previously reported (stratified HR = 0.69 [95% CI: 0.55– 0.86]); the median OS was not reached with durvalumab but was 29.1 months with placebo. The 12-, 24- and 36- month OS rates with durvalumab and placebo were 83.1% versus 74.6%, 66.3% versus 55.3%, and 57.0% versus 43.5%, respectively. All secondary outcomes examined showed improvements consistent with previous analyses. Conclusions: Updated OS data from PACIFIC, including 3-year survival rates, demonstrate the long-term clinical benefit with durvalumab after chemoradiotherapy and further establish the PACIFIC regimen as the standard of care in this population.
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Affiliation(s)
- Jhanelle E Gray
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
| | | | - Davey Daniel
- Tennessee Oncology, Chattanooga, Tennessee; Sarah Cannon Research Institute, Nashville, Tennessee
| | | | | | - Rina Hui
- Westmead Hospital, Sydney, New South Wales, Australia; University of Sydney, Sydney, New South Wales, Australia
| | | | | | - Ki Hyeong Lee
- Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Byoung Chul Cho
- Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | - Luis Paz-Ares
- University Hospital October 12, CiberOnc, Complutense University of Madrid, Madrid, Spain; National Cancer Research Center, Madrid, Spain
| | - Corinne Faivre-Finn
- The University of Manchester and The Christie National Health Service Foundation Trust, Manchester, United Kingdom
| | | | | | | | | | | | - Mustafa Özgüroğlu
- Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Scott J Antonia
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
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Hui R, Özgüroğlu M, Villegas A, Daniel D, Vicente D, Murakami S, Yokoi T, Chiappori A, Lee KH, de Wit M, Cho BC, Gray JE, Rydén A, Viviers L, Poole L, Zhang Y, Dennis PA, Antonia SJ. Patient-reported outcomes with durvalumab after chemoradiotherapy in stage III, unresectable non-small-cell lung cancer (PACIFIC): a randomised, controlled, phase 3 study. Lancet Oncol 2019; 20:1670-1680. [PMID: 31601496 DOI: 10.1016/s1470-2045(19)30519-4] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND In the ongoing, phase 3 PACIFIC trial, durvalumab improved the primary endpoints of progression-free survival and overall survival compared with that for placebo, with similar safety, in patients with unresectable, stage III non-small-cell lung cancer. In this analysis, we aimed to evaluate one of the secondary endpoints, patient-reported outcomes (PROs). METHODS PACIFIC is an ongoing, international, multicentre, double-blind, randomised, controlled, phase 3 trial. Eligible patients were aged at least 18 years, had a WHO performance status of 0 or 1, with histologically or cytologically documented stage III, unresectable non-small-cell lung cancer, for which they had received at least two cycles of platinum-based chemoradiotherapy, with no disease progression after this treatment. We randomly assigned patients (2:1) using an interactive voice response system and a blocked design (block size=3) stratified by age, sex, and smoking history to receive 10 mg/kg intravenous durvalumab or matching placebo 1-42 days after concurrent chemoradiotherapy, then every 2 weeks up to 12 months. The primary endpoints of progression-free survival and overall survival have been reported previously. PROs were a prespecified secondary outcome. We assessed PRO symptoms, functioning, and global health status or quality of life in the intention-to-treat population with the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) version 3 and its lung cancer module, the Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) at the time of random allocation to groups, at weeks 4 and 8, every 8 weeks until week 48, and then every 12 weeks until progression. Changes from baseline to 12 month in key symptoms were analysed with mixed model for repeated measures (MMRM) and time-to-event analyses. A 10-point or greater change from baseline (deterioration or improvement) was deemed clinically relevant. This study is registered with ClinicalTrials.gov, NCT02125461, and EudraCT, 2014-000336-42. FINDINGS Between May 9, 2014, and April 22, 2016, 476 patients were assigned to receive durvalumab, and 237 patients were assigned to receive placebo. As of March 22, 2018, the median follow-up was 25·2 months (IQR 14·1-29·5). More than 79% of patients given durvalumab and more than 82% of patients given placebo completed questionnaires up to week 48. Between baseline and 12 months, the prespecified longitudinal PROs of interest, cough (MMRM-adjusted mean change 1·8 [95% CI 0·06 to 3·54] in the durvalumab group vs 0·7 [-1·91 to 3·30] in the placebo group), dyspnoea (3·1 [1·75 to 4·36] vs 1·4 [-0·51 to 3·34]), chest pain (-3·1 [-4·57 to -1·60] vs -3·5 [-5·68 to -1·29]), fatigue (-3·0 [-4·53 to -1·50] vs -5·2 [-7·45 to -2·98]), appetite loss (-5·8 [-7·28 to -4·36] vs -7·0 [-9·17 to -4·87]), physical functioning (0·1 [-1·10 to 1·28] vs 2·0 [0·22 to 3·73]), and global health status or quality of life (2·6 [1·21 to 3·94] vs 1·8 [-0·25 to 3·81]) remained stable with both treatments, with no clinically relevant changes from baseline. The between-group differences in changes from baseline to 12 months in cough (difference in adjusted mean changes 1·1, 95% CI -1·89 to 4·11), dyspnoea (1·6, -0·58 to 3·87), chest pain (0·4, -2·13 to 2·93), fatigue (2·2, -0·38 to 4·78), appetite loss (1·2, -1·27 to 3·67), physical functioning (-1·9, -3·91 to 0·15), or global health status or quality of life (0·8, -1·55 to 3·14) were not clinically relevant. Generally, there were no clinically important between-group differences in time to deterioration of prespecified key PRO endpoints. INTERPRETATION Our findings suggest that a clinical benefit with durvalumab can be attained without compromising PROs. This result is of note because the previous standard of care was observation alone, with no presumed detriment to PROs. FUNDING AstraZeneca.
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Affiliation(s)
- Rina Hui
- Department of Medical Oncology, Westmead Hospital and the University of Sydney, Sydney, NSW, Australia.
| | - Mustafa Özgüroğlu
- Division of Medical Oncology, Department of Internal Medicine, Cerrahpaşa School of Medicine, Istanbul University Cerrahpaşa, Istanbul, Turkey
| | | | - Davey Daniel
- Sarah Cannon Research Institute, Nashville and Tennessee Oncology, Chattanooga, TN, USA
| | - David Vicente
- Department of Medical Oncology, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Shuji Murakami
- Department of Thoracic Oncology, Kanagawa Cancer Centre, Kanagawa, Japan
| | - Takashi Yokoi
- Department of Thoracic Oncology, Kansai Medical University Hospital, Hirakata, Japan
| | - Alberto Chiappori
- Thoracic Oncology Program, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Ki Hyeong Lee
- Department of Internal Medicine, College of Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Maike de Wit
- Department of Internal Medicine-Hematology, Oncology and Palliative Medicine, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Byoung Chul Cho
- Department of Internal Medicine, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, South Korea
| | - Jhanelle E Gray
- Thoracic Oncology Program, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | | | | | | | | | - Scott J Antonia
- Thoracic Oncology Program, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Vansteenkiste J, Naidoo J, Faivre-Finn C, Özgüroğlu M, Villegas A, Daniel D, Murakami S, Hui R, Lee K, Cho B, Kubota K, Taboada M, Wadsworth C, Dennis P, Antonia S. Efficacy of durvalumab in patients with stage III NSCLC who experience pneumonitis (PACIFIC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz259.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Daniel D, Kuchava V, Bondarenko I, Ivashchuk O, Spigel D, Dasgupta A, Reddy S, Melkadze T, Jaal J, Kudaba I, Hart L, Matitashvili A, Koynov K, Yang Z, Wolfe S, Malik R, Morris S, Antal J, Goldschmidt J. Trilaciclib (T) decreases myelosuppression in extensive-stage small cell lung cancer (ES-SCLC) patients receiving first-line chemotherapy plus atezolizumab. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz264.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Alkimin GD, Daniel D, Dionísio R, Soares AMVM, Barata C, Nunes B. Effects of diclofenac and salicylic acid exposure on Lemna minor: Is time a factor? Environ Res 2019; 177:108609. [PMID: 31376628 DOI: 10.1016/j.envres.2019.108609] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 07/25/2019] [Accepted: 07/25/2019] [Indexed: 06/10/2023]
Abstract
The global occurrence of pharmaceuticals in the aquatic environment has been considered a particularly concerning problem with unknown consequences. Non-steroidal anti-inflammatory drugs (NSAIDs) including diclofenac (DCF) and salicylic acid (SA), are among the most frequently prescribed drugs in the world, being consequently commonly found in the aquatic environment. Prolonged experiments (with duration of exposure that surpass those recommended by already established testing guidelines) are important to obtain ecologically relevant data to address the issue of NSAIDs ecotoxicity, because by being more realistically (namely in terms of levels and durations of exposure), such tests may indicate realistic challenges posed to aquatic organisms. Among the most common test species that are used for assessing environmental quality, plants play a leading role. Lemna species are among the most important plants used for ecotoxicity testing. Therefore, the aim of this study was to evaluate the temporal effect of a prolonged exposure of DCF and SA on Lemna minor. To attain this purpose, L. minor plants were chronically exposed to 0, 4, 20, and 100 μg/L of both pharmaceuticals, and samplings were performed at 6, 10 and 14 days of exposure. The analyzed endpoints were: levels of chlorophyll a, b and total, carotenoids; and enzymatic biomarkers, such as catalase, ascorbate peroxidase and glutathione-S-transferases. Diclofenac was responsible for alterations in all analyzed parameters in different intervals of exposure. Salicylic acid exposure was not capable of causing alterations on pigment contents of L. minor, however, enzymatic biomarkers were altered at all sampling intervals. Thus, it is possible to conclude that both pharmaceuticals can cause damage on the tested macrophyte species, biochemical parameters being more sensitive than physiological ones. Additional prolonged experiments are required to understand the chronic effects of different pharmaceuticals in the aquatic environment, especially in plants.
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Affiliation(s)
- G D Alkimin
- Departamento de Biologia da Universidade de Aveiro, Campus de Santiago, 3810-193, Aveiro, Portugal; Centro de Estudos do Ambiente e do Mar (CESAM), Campus de Santiago, Universidade de Aveiro, 3810-193, Aveiro, Portugal
| | - D Daniel
- Departamento de Biologia da Universidade de Aveiro, Campus de Santiago, 3810-193, Aveiro, Portugal
| | - R Dionísio
- Departamento de Biologia da Universidade de Aveiro, Campus de Santiago, 3810-193, Aveiro, Portugal
| | - A M V M Soares
- Departamento de Biologia da Universidade de Aveiro, Campus de Santiago, 3810-193, Aveiro, Portugal; Centro de Estudos do Ambiente e do Mar (CESAM), Campus de Santiago, Universidade de Aveiro, 3810-193, Aveiro, Portugal
| | - C Barata
- Department of Environmental Chemistry, IDAEA-CSIC, Jordi Girona 18, 08034, Barcelona, Spain
| | - B Nunes
- Departamento de Biologia da Universidade de Aveiro, Campus de Santiago, 3810-193, Aveiro, Portugal; Centro de Estudos do Ambiente e do Mar (CESAM), Campus de Santiago, Universidade de Aveiro, 3810-193, Aveiro, Portugal.
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West H, McCleod M, Hussein M, Morabito A, Rittmeyer A, Conter HJ, Kopp HG, Daniel D, McCune S, Mekhail T, Zer A, Reinmuth N, Sadiq A, Sandler A, Lin W, Ochi Lohmann T, Archer V, Wang L, Kowanetz M, Cappuzzo F. Atezolizumab in combination with carboplatin plus nab-paclitaxel chemotherapy compared with chemotherapy alone as first-line treatment for metastatic non-squamous non-small-cell lung cancer (IMpower130): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol 2019. [PMID: 31122901 DOI: 10.1016/s1470-2045(19)30167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
BACKGROUND Atezolizumab (a monoclonal antibody against PD-L1), which restores anticancer immunity, improved overall survival in patients with previously treated non-small-cell lung cancer and also showed clinical benefit when combined with chemotherapy as first-line treatment of non-small-cell lung cancer. IMpower130 aimed to assess the efficacy and safety of atezolizumab plus chemotherapy versus chemotherapy alone as first-line therapy for non-squamous non-small-cell lung cancer. METHODS IMpower130 was a multicentre, randomised, open-label, phase 3 study done in 131 centres across eight countries (the USA, Canada, Belgium, France, Germany, Italy, Spain, and Israel). Eligible patients were aged 18 years or older, and had histologically or cytologically confirmed stage IV non-squamous non-small-cell lung cancer, an Eastern Cooperative Oncology Group performance status of 0 or 1, and received no previous chemotherapy for stage IV disease. Patients were randomly assigned (2:1; permuted block [block size of six] with an interactive voice or web response system) to receive atezolizumab (1200 mg intravenously every 3 weeks) plus chemotherapy (carboplatin [area under the curve 6 mg/mL per min every 3 weeks] plus nab-paclitaxel [100 mg/m2 intravenously every week]) or chemotherapy alone for four or six 21-day cycles followed by maintenance therapy. Stratification factors were sex, baseline liver metastases, and PD-L1 tumour expression. Co-primary endpoints were investigator-assessed progression-free survival and overall survival in the intention-to-treat wild-type (ie, EGFRwt and ALKwt) population. The safety population included patients who received at least one dose of the study drug. This study is registered with ClinicalTrials.gov, number NCT02367781. FINDINGS Between April 16, 2015, and Feb 13, 2017, 724 patients were randomly assigned and 723 were included in the intention-to-treat population (one patient died before randomisation, but was assigned to a treatment group; this patient was excluded from the intention-to-treat population) of the atezolizumab plus chemotherapy group (483 patients in the intention-to-treat population and 451 patients in the intention-to-treat wild-type population) or the chemotherapy group (240 patients in the intention-to-treat population and 228 patients in the intention-to-treat wild-type population). Median follow-up in the intention-to-treat wild-type population was similar between groups (18·5 months [IQR 15·2-23·6] in the atezolizumab plus chemotherapy group and 19·2 months [15·4-23·0] in the chemotherapy group). In the intention-to-treat wild-type population, there were significant improvements in median overall survival (18·6 months [95% CI 16·0-21·2] in the atezolizumab plus chemotherapy group and 13·9 months [12·0-18·7] in the chemotherapy group; stratified hazard ratio [HR] 0·79 [95% CI 0·64-0·98]; p=0·033) and median progression-free survival (7·0 months [95% CI 6·2-7·3] in the atezolizumab plus chemotherapy group and 5·5 months [4·4-5·9] in the chemotherapy group; stratified HR 0·64 [95% CI 0·54-0·77]; p<0·0001]). The most common grade 3 or worse treatment-related adverse events were neutropenia (152 [32%] of 473 in the atezolizumab plus chemotherapy group vs 65 [28%] of 232 in the chemotherapy group), anaemia (138 [29%] vs 47 [20%]), and decreased neutrophil count (57 [12%] vs 19 [8%]). Treatment-related serious adverse events were reported in 112 (24%) of 473 patients in the atezolizumab plus chemotherapy group and 30 (13%) of 232 patients in the chemotherapy group. Treatment-related (any treatment) deaths occurred in eight (2%) of 473 patients in the atezolizumab plus chemotherapy group and one (<1%) of 232 patients in the chemotherapy group. INTERPRETATION IMpower130 showed a significant and clinically meaningful improvement in overall survival and a significant improvement in progression-free survival with atezolizumab plus chemotherapy versus chemotherapy as first-line treatment of patients with stage IV non-squamous non-small-cell lung cancer and no ALK or EGFR mutations. No new safety signals were identified. This study supports the benefit of atezolizumab, in combination with platinum-based chemotherapy, as first-line treatment of metastatic non-small-cell lung cancer. FUNDING F. Hoffmann-La Roche.
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Affiliation(s)
- Howard West
- Thoracic Oncology Program, Swedish Cancer Institute, Seattle, WA, USA
| | - Michael McCleod
- Sarah Cannon Research Institute, Florida Cancer Specialists, Fort Myers, FL, USA
| | - Maen Hussein
- Sarah Cannon Research Institute, Florida Cancer Specialists, Leesburg, FL, USA
| | - Alessandro Morabito
- Thoracic Medical Oncology, National Cancer Institute, IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Achim Rittmeyer
- Department of Thoracic Oncology, Lungenfachklinik Immenhausen, Immenhausen, Germany
| | - Henry J Conter
- Department of Medicine, William Osler Health System, Brampton, ON, Canada
| | - Hans-Georg Kopp
- Robert Bosch Centrum für Tumorerkrankungen, Klinik Schillerhöhe, Stuttgart, Germany
| | | | - Steven McCune
- Northwest Georgia Oncology Centers, Marietta, GA, USA
| | | | - Alona Zer
- Thoracic Oncology Unit, Rabin Medical Center, Tel Aviv University, Petah-Tikva, Israel
| | - Niels Reinmuth
- Thoracic Oncology, Asklepios Clinics Munich-Gauting, Gauting, Germany
| | - Ahad Sadiq
- Fort Wayne Medical Oncology and Hematology, Fort Wayne, IN, USA
| | - Alan Sandler
- Clinical Science, Genentech, South San Francisco, CA, USA
| | - Wei Lin
- Clinical Science, Genentech, South San Francisco, CA, USA; Nektar Therapeutics, San Francisco, CA, USA
| | | | | | - Lijia Wang
- Biostatistics, Genentech, South San Francisco, CA, USA
| | - Marcin Kowanetz
- Oncology Biomarker Development, Genentech, South San Francisco, CA, USA; Biotherapeutics, Inc., Redwood City, CA, USA
| | - Federico Cappuzzo
- Department of Oncology and Hematology, AUSL Romagna, Ravenna, Italy.
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West HL, McCleod M, Hussein M, Morabito A, Rittmeyer A, Conter HJ, Kopp HG, Daniel D, McCune S, Mekhail T, Zer A, Reinmuth N, Sadiq A, Archer V, Lohmann TO, Jessop H, Wang L, Kowanetz M, Sandler A, Cappuzzo F. Abstract CT200: IMpower130: Progression-free survival (PFS) and safety analysis from a randomized phase 3 study of carboplatin + nab-paclitaxel (CnP) with or without atezolizumab as first-line (1L) therapy in advanced non-squamous NSCLC. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-ct200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Atezolizumab (atezo) (anti-PD-L1) monotherapy improves overall survival (OS) vs docetaxel in 2L+ NSCLC regardless of PD-L1 status; phase 3, 1L studies have shown clinical benefit of atezo plus chemotherapy and atezo in combination with bevacizumab and chemotherapy. IMpower130 (NCT02367781) evaluated atezo + CnP vs CnP in patients (pts) with measurable (RECIST v1.1) stage IV non-squamous NSCLC.
Methods: Pts (randomized 2:1) received atezo (1200 mg IV q3w) + CnP (carboplatin: AUC 6 q3w; nab-paclitaxel: 100 mg/m2 IV qw) (Arm A) or CnP (Arm B), for 4 or 6 21-day cycles and maintenance (Arm A: atezo until loss of clinical benefit; Arm B: best supportive care or pemetrexed q3w until disease progression [PD]). Crossover to atezo at PD was initially permitted for Arm B pts. Co-primary endpoints were investigator-assessed PFS and OS (ITT-WT population: EGFR-WT/ALK-negative). Secondary endpoints were OS and PFS (ITT population and by PD-L1 expression), response rate and safety. ITT population could be formally tested for OS/PFS if ITT-WT OS was positive.
Results: 723 ITT (679 ITT-WT) pts were enrolled. Statistically significant, clinically meaningful improvements in OS and statistically significant and clinically meaningful improvements in PFS (ITT and ITT-WT) were observed in Arm A vs Arm B (table). PFS and OS benefit was observed in all PD-L1 subgroups, and consistently across all subgroups, except in pts with liver metastases and EGFR/ALK genomic alterations. In treated pts, 73.2% (Arm A) vs 60.3% (Arm B) had grade 3-4 treatment-related adverse events.
Conclusions: Overall, IMpower130 showed statistically significant, clinically meaningful improvements in OS and statistically significant improvements in PFS with atezo + CnP, vs CnP, in 1L, stage IV non-squamous NSCLC, in this predominantly ITT-WT population. No new safety signals were identified.
Table.IMpower130 Efficacy AnalysesArm A Atezo + CnPArm B CnPITT-WTn = 451n = 228Median OS (95% CI)18.6 mo (16.0-21.2)13.9 mo (12.0-18.7)HR (95% CI; P value)0.79 (0.64-0.98; 0.033)12-mo OS (95% CI)63.1% (58.59-67.66)55.5% (48.89-62.17)Median PFS (95% CI)7.0 mo (6.2-7.3)5.5 mo (4.4-5.9)HR (95% CI; P value)0.64 (0.54-0.77; < 0.0001)12-mo PFS (95% CI)29.1% (24.83-33.44)14.1% (9.37-18.76)n = 447n = 226Confirmed ORR (investigator assessed) (95% CI)49.2% (44.49-53.96)31.9% (25.84-38.36)n = 220n = 72Median DOR (95% CI)8.4 mo (6.9-11.8)6.1 mo (5.5-7.9)PD-L1 highan = 88n = 42Median OS (95% CI)17.4 mo (14.78-NA)16.9 mo (10.94-NA)HR (95% CI)0.84 (0.51-1.39)Median PFS (95% CI)6.4 mo (5.49-9.76)4.6 mo (3.22-7)HR (95% CI)0.51 (0.34-0.77)PD-L1 lowan = 128n = 65Median OS (95% CI)23.7 mo (18.63-NA)15.9 mo (12.32-25.63)HR (95% CI)0.70 (0.45-1.08)Median PFS (95% CI)8.3 mo (7.16-10.35)6.0 mo (5.29-6.93)HR (95% CI)0.61 (0.43-0.85)PD-L1 negativean = 235n = 121Median OS (95% CI)15.2 mo (12.88-19.15)12.0 mo (8.97-17.71)HR (95% CI)0.81 (0.61-1.08)Median PFS (95% CI)6.2 mo (5.52-7.16)4.7 mo (4.11-5.72)HR (95% CI)0.72 (0.56-0.91)ITTn = 483n = 240Median OS (95% CI)18.1 mo (15.3-20.8)13.9 mo (12.0-18.2)HR (95% CI; P value)0.80 (0.65-0.99; 0.039)Median PFS (95% CI)7.0 mo (6.3-7.3)5.6 mo (4.5-5.9)HR (95% CI; P value)0.65 (0.54-0.77; < 0.0001)a PD-L1 high (TC3 or IC3): Patients with PD-L1 expression in ≥ 50% of tumor cells or ≥ 10% of tumor-infiltrating immune cells; PD-L1 low (TC1/2 or IC1/2): Patients with PD-L1 expression in ≥ 1% and < 50% of tumor cells or ≥ 1% and <10% of tumor-infiltrating immune cells; and PD-L1 negative (TC0 and IC0): Patients with PD-L1 expression in <1% of tumor cells and < 1% of tumor-infiltrating immune cells. Data cut-off: 15 March 2018. Minimum follow up: 13 months. NCT02367781.DOR, duration of response; HR, hazard ratio; IC, immune cells; ORR, objective response rate; OS, overall survival; PFS, progression-free survival; TC, tumor cells.
Citation Format: Howard L. West, Michael McCleod, Maen Hussein, Alessandro Morabito, Achim Rittmeyer, Henry J. Conter, Hans-Georg Kopp, Davey Daniel, Steven McCune, Tarek Mekhail, Alona Zer, Niels Reinmuth, Ahad Sadiq, Venice Archer, Tania Ochi Lohmann, Helen Jessop, Lijia Wang, Marcin Kowanetz, Alan Sandler, Federico Cappuzzo. IMpower130: Progression-free survival (PFS) and safety analysis from a randomized phase 3 study of carboplatin + nab-paclitaxel (CnP) with or without atezolizumab as first-line (1L) therapy in advanced non-squamous NSCLC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr CT200.
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Affiliation(s)
| | - Michael McCleod
- 2Sarah Cannon Research Institute / Florida Cancer Specialists, Fort Myers, FL
| | - Maen Hussein
- 3Sarah Cannon Research Institute / Florida Cancer Specialists, Leesburg, FL
| | - Alessandro Morabito
- 4Thoracic Medical Oncology, Istituto Nazionale Tumori, IRCCS “Fondazione G. Pascale”, Naples, Italy
| | - Achim Rittmeyer
- 5Department of Thoracic Oncology, Lungenfachklinik Immenhausen, Immenhausen, Germany
| | - Henry J. Conter
- 6Department of Medicine,William Osler Health System, Ontario, Ontario, Canada
| | - Hans-Georg Kopp
- 7Robert Bosch Centrum für Tumorerkrankungen, Klinik Schillerhöhe, Stuttgart, Germany
| | | | | | | | - Alona Zer
- 11Thoracic Oncology Unit, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Niels Reinmuth
- 12Thoracic Oncology, Asklepios Clinics Munich-Gauting, Gauting, Germany
| | - Ahad Sadiq
- 13Fort Wayne Medical Oncology and Hematology, Fort Wayne, IN
| | - Venice Archer
- 14Roche Products Limited, Welwyn Garden City, United Kingdom
| | | | - Helen Jessop
- 16F. Hoffmann-La Roche, Ltd., Basel, Switzerland
| | - Lijia Wang
- 17Genentech, Inc., South San Francisco, CA
| | | | | | - Federico Cappuzzo
- 18Dipartimento di Oncologia Medica, Azienda Unità Sanitaria Locale della Romagna, Ravenna, Italy
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West H, McCleod M, Hussein M, Morabito A, Rittmeyer A, Conter HJ, Kopp HG, Daniel D, McCune S, Mekhail T, Zer A, Reinmuth N, Sadiq A, Sandler A, Lin W, Ochi Lohmann T, Archer V, Wang L, Kowanetz M, Cappuzzo F. Atezolizumab in combination with carboplatin plus nab-paclitaxel chemotherapy compared with chemotherapy alone as first-line treatment for metastatic non-squamous non-small-cell lung cancer (IMpower130): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol 2019; 20:924-937. [PMID: 31122901 DOI: 10.1016/s1470-2045(19)30167-6] [Citation(s) in RCA: 979] [Impact Index Per Article: 195.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/22/2019] [Accepted: 02/26/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Atezolizumab (a monoclonal antibody against PD-L1), which restores anticancer immunity, improved overall survival in patients with previously treated non-small-cell lung cancer and also showed clinical benefit when combined with chemotherapy as first-line treatment of non-small-cell lung cancer. IMpower130 aimed to assess the efficacy and safety of atezolizumab plus chemotherapy versus chemotherapy alone as first-line therapy for non-squamous non-small-cell lung cancer. METHODS IMpower130 was a multicentre, randomised, open-label, phase 3 study done in 131 centres across eight countries (the USA, Canada, Belgium, France, Germany, Italy, Spain, and Israel). Eligible patients were aged 18 years or older, and had histologically or cytologically confirmed stage IV non-squamous non-small-cell lung cancer, an Eastern Cooperative Oncology Group performance status of 0 or 1, and received no previous chemotherapy for stage IV disease. Patients were randomly assigned (2:1; permuted block [block size of six] with an interactive voice or web response system) to receive atezolizumab (1200 mg intravenously every 3 weeks) plus chemotherapy (carboplatin [area under the curve 6 mg/mL per min every 3 weeks] plus nab-paclitaxel [100 mg/m2 intravenously every week]) or chemotherapy alone for four or six 21-day cycles followed by maintenance therapy. Stratification factors were sex, baseline liver metastases, and PD-L1 tumour expression. Co-primary endpoints were investigator-assessed progression-free survival and overall survival in the intention-to-treat wild-type (ie, EGFRwt and ALKwt) population. The safety population included patients who received at least one dose of the study drug. This study is registered with ClinicalTrials.gov, number NCT02367781. FINDINGS Between April 16, 2015, and Feb 13, 2017, 724 patients were randomly assigned and 723 were included in the intention-to-treat population (one patient died before randomisation, but was assigned to a treatment group; this patient was excluded from the intention-to-treat population) of the atezolizumab plus chemotherapy group (483 patients in the intention-to-treat population and 451 patients in the intention-to-treat wild-type population) or the chemotherapy group (240 patients in the intention-to-treat population and 228 patients in the intention-to-treat wild-type population). Median follow-up in the intention-to-treat wild-type population was similar between groups (18·5 months [IQR 15·2-23·6] in the atezolizumab plus chemotherapy group and 19·2 months [15·4-23·0] in the chemotherapy group). In the intention-to-treat wild-type population, there were significant improvements in median overall survival (18·6 months [95% CI 16·0-21·2] in the atezolizumab plus chemotherapy group and 13·9 months [12·0-18·7] in the chemotherapy group; stratified hazard ratio [HR] 0·79 [95% CI 0·64-0·98]; p=0·033) and median progression-free survival (7·0 months [95% CI 6·2-7·3] in the atezolizumab plus chemotherapy group and 5·5 months [4·4-5·9] in the chemotherapy group; stratified HR 0·64 [95% CI 0·54-0·77]; p<0·0001]). The most common grade 3 or worse treatment-related adverse events were neutropenia (152 [32%] of 473 in the atezolizumab plus chemotherapy group vs 65 [28%] of 232 in the chemotherapy group), anaemia (138 [29%] vs 47 [20%]), and decreased neutrophil count (57 [12%] vs 19 [8%]). Treatment-related serious adverse events were reported in 112 (24%) of 473 patients in the atezolizumab plus chemotherapy group and 30 (13%) of 232 patients in the chemotherapy group. Treatment-related (any treatment) deaths occurred in eight (2%) of 473 patients in the atezolizumab plus chemotherapy group and one (<1%) of 232 patients in the chemotherapy group. INTERPRETATION IMpower130 showed a significant and clinically meaningful improvement in overall survival and a significant improvement in progression-free survival with atezolizumab plus chemotherapy versus chemotherapy as first-line treatment of patients with stage IV non-squamous non-small-cell lung cancer and no ALK or EGFR mutations. No new safety signals were identified. This study supports the benefit of atezolizumab, in combination with platinum-based chemotherapy, as first-line treatment of metastatic non-small-cell lung cancer. FUNDING F. Hoffmann-La Roche.
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Affiliation(s)
- Howard West
- Thoracic Oncology Program, Swedish Cancer Institute, Seattle, WA, USA
| | - Michael McCleod
- Sarah Cannon Research Institute, Florida Cancer Specialists, Fort Myers, FL, USA
| | - Maen Hussein
- Sarah Cannon Research Institute, Florida Cancer Specialists, Leesburg, FL, USA
| | - Alessandro Morabito
- Thoracic Medical Oncology, National Cancer Institute, IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Achim Rittmeyer
- Department of Thoracic Oncology, Lungenfachklinik Immenhausen, Immenhausen, Germany
| | - Henry J Conter
- Department of Medicine, William Osler Health System, Brampton, ON, Canada
| | - Hans-Georg Kopp
- Robert Bosch Centrum für Tumorerkrankungen, Klinik Schillerhöhe, Stuttgart, Germany
| | | | - Steven McCune
- Northwest Georgia Oncology Centers, Marietta, GA, USA
| | | | - Alona Zer
- Thoracic Oncology Unit, Rabin Medical Center, Tel Aviv University, Petah-Tikva, Israel
| | - Niels Reinmuth
- Thoracic Oncology, Asklepios Clinics Munich-Gauting, Gauting, Germany
| | - Ahad Sadiq
- Fort Wayne Medical Oncology and Hematology, Fort Wayne, IN, USA
| | - Alan Sandler
- Clinical Science, Genentech, South San Francisco, CA, USA
| | - Wei Lin
- Clinical Science, Genentech, South San Francisco, CA, USA; Nektar Therapeutics, San Francisco, CA, USA
| | | | | | - Lijia Wang
- Biostatistics, Genentech, South San Francisco, CA, USA
| | - Marcin Kowanetz
- Oncology Biomarker Development, Genentech, South San Francisco, CA, USA; Biotherapeutics, Inc., Redwood City, CA, USA
| | - Federico Cappuzzo
- Department of Oncology and Hematology, AUSL Romagna, Ravenna, Italy.
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Alkimin GD, Daniel D, Frankenbach S, Serôdio J, Soares AMVM, Barata C, Nunes B. Evaluation of pharmaceutical toxic effects of non-standard endpoints on the macrophyte species Lemna minor and Lemna gibba. Sci Total Environ 2019; 657:926-937. [PMID: 30677958 DOI: 10.1016/j.scitotenv.2018.12.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/15/2018] [Accepted: 12/01/2018] [Indexed: 06/09/2023]
Abstract
In the last years the environmental presence of pharmaceuticals has gained increasing attention. Research data show that these compounds can cause toxicological effects in different species of fish, mollusks and macroinvertebrates. However, the literature is scarce in terms of ecotoxicity data especially focusing on plants as test organisms. Ecotoxicological plant-based tests following the standard OEDC guideline 221 (OECD, 2006) are strongly restricted due to the recommended end-points: growth and yield of plants. It is necessary to develop and validate alternative macrophyte-based tests (non-standard endpoints), more sensible and providing additional information about the chemical contamination effects in plants. To attain this purpose, species from the Lemna genus were selected. Thus, the aim of this study was to analyze the toxic effects of pharmaceuticals in non-standard endpoints on two macrophyte species, Lemna minor and Lemna gibba. To this purpose an acute assay (96 h) was performed with L. minor and L. gibba exposed to chlorpromazine (CPZ), paracetamol (APAP), and diclofenac (DCF), in the following concentration ranges: 0 to 20 μg/L, 0 to 125 μg/L, and 0 to 100 μg/L, respectively. The analyzed endpoints were: levels of chlorophyll a and b, total chlorophyll, carotenoids, anthocyanins; chlorophyll fluorescence; and catalase activity. In general, higher concentrations of the tested pharmaceuticals caused significant effects on both Lemna species in terms of the different endpoints analyzed. In conclusion, acute exposures to CPZ, APAP, and DCF differently affected the defensive system of the tested species; among chlorophylls, chlorophyll b content was more affected, but pharmaceutical exposure was not able to cause alterations on chlorophyll fluorescence.
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Affiliation(s)
- G D Alkimin
- Department of Biology, Aveiro University, Campus de Santiago, 3810-193 Aveiro, Portugal; Centre for Environmental and Marine Studies (CESAM), Campus de Santiago, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - D Daniel
- Department of Biology, Aveiro University, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - S Frankenbach
- Department of Biology, Aveiro University, Campus de Santiago, 3810-193 Aveiro, Portugal; Centre for Environmental and Marine Studies (CESAM), Campus de Santiago, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - J Serôdio
- Department of Biology, Aveiro University, Campus de Santiago, 3810-193 Aveiro, Portugal; Centre for Environmental and Marine Studies (CESAM), Campus de Santiago, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - A M V M Soares
- Department of Biology, Aveiro University, Campus de Santiago, 3810-193 Aveiro, Portugal; Centre for Environmental and Marine Studies (CESAM), Campus de Santiago, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - C Barata
- Department of Environmental Chemistry, IDAEA-CSIC, Jordi Girona 18, 08034 Barcelona, Spain
| | - B Nunes
- Department of Biology, Aveiro University, Campus de Santiago, 3810-193 Aveiro, Portugal; Centre for Environmental and Marine Studies (CESAM), Campus de Santiago, Universidade de Aveiro, 3810-193 Aveiro, Portugal.
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Antonia SJ, Villegas A, Daniel D, Vicente D, Murakami S, Hui R, Kurata T, Chiappori A, Lee KH, de Wit M, Cho BC, Bourhaba M, Quantin X, Tokito T, Mekhail T, Planchard D, Kim YC, Karapetis CS, Hiret S, Ostoros G, Kubota K, Gray JE, Paz-Ares L, de Castro Carpeño J, Faivre-Finn C, Reck M, Vansteenkiste J, Spigel DR, Wadsworth C, Melillo G, Taboada M, Dennis PA, Özgüroğlu M. Overall Survival with Durvalumab after Chemoradiotherapy in Stage III NSCLC. N Engl J Med 2018; 379:2342-2350. [PMID: 30280658 DOI: 10.1056/nejmoa1809697] [Citation(s) in RCA: 1807] [Impact Index Per Article: 301.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND An earlier analysis in this phase 3 trial showed that durvalumab significantly prolonged progression-free survival, as compared with placebo, among patients with stage III, unresectable non-small-cell lung cancer (NSCLC) who did not have disease progression after concurrent chemoradiotherapy. Here we report the results for the second primary end point of overall survival. METHODS We randomly assigned patients, in a 2:1 ratio, to receive durvalumab intravenously, at a dose of 10 mg per kilogram of body weight, or matching placebo every 2 weeks for up to 12 months. Randomization occurred 1 to 42 days after the patients had received chemoradiotherapy and was stratified according to age, sex, and smoking history. The primary end points were progression-free survival (as assessed by blinded independent central review) and overall survival. Secondary end points included the time to death or distant metastasis, the time to second progression, and safety. RESULTS Of the 713 patients who underwent randomization, 709 received the assigned intervention (473 patients received durvalumab and 236 received placebo). As of March 22, 2018, the median follow-up was 25.2 months. The 24-month overall survival rate was 66.3% (95% confidence interval [CI], 61.7 to 70.4) in the durvalumab group, as compared with 55.6% (95% CI, 48.9 to 61.8) in the placebo group (two-sided P=0.005). Durvalumab significantly prolonged overall survival, as compared with placebo (stratified hazard ratio for death, 0.68; 99.73% CI, 0.47 to 0.997; P=0.0025). Updated analyses regarding progression-free survival were similar to those previously reported, with a median duration of 17.2 months in the durvalumab group and 5.6 months in the placebo group (stratified hazard ratio for disease progression or death, 0.51; 95% CI, 0.41 to 0.63). The median time to death or distant metastasis was 28.3 months in the durvalumab group and 16.2 months in the placebo group (stratified hazard ratio, 0.53; 95% CI, 0.41 to 0.68). A total of 30.5% of the patients in the durvalumab group and 26.1% of those in the placebo group had grade 3 or 4 adverse events of any cause; 15.4% and 9.8% of the patients, respectively, discontinued the trial regimen because of adverse events. CONCLUSIONS Durvalumab therapy resulted in significantly longer overall survival than placebo. No new safety signals were identified. (Funded by AstraZeneca; PACIFIC ClinicalTrials.gov number, NCT02125461 .).
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Affiliation(s)
- Scott J Antonia
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Augusto Villegas
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Davey Daniel
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - David Vicente
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Shuji Murakami
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Rina Hui
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Takayasu Kurata
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Alberto Chiappori
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Ki H Lee
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Maike de Wit
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Byoung C Cho
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Maryam Bourhaba
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Xavier Quantin
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Takaaki Tokito
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Tarek Mekhail
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - David Planchard
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Young-Chul Kim
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Christos S Karapetis
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Sandrine Hiret
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Gyula Ostoros
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Kaoru Kubota
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Jhanelle E Gray
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Luis Paz-Ares
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Javier de Castro Carpeño
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Corinne Faivre-Finn
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Martin Reck
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Johan Vansteenkiste
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - David R Spigel
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Catherine Wadsworth
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Giovanni Melillo
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Maria Taboada
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Phillip A Dennis
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
| | - Mustafa Özgüroğlu
- From the H. Lee Moffitt Cancer Center and Research Institute, Tampa (S.J.A., A.C., J.E.G.), Cancer Specialists of North Florida, Jacksonville (A.V.), Florida Cancer Specialists, Fleming Island (A.V.), and Florida Hospital Cancer Institute, Orlando (T.M.) - all in Florida; Tennessee Oncology, Chattanooga (D.D.), and Sarah Cannon Research Institute, Nashville (D.D., D.R.S.) - both in Tennessee; Hospital Universitario Virgen Macarena, Seville (D.V.), and Hospital Universitario 12 de Octubre, CiberOnc, Universidad Complutense and Spanish National Cancer Research Center (L.P.-A.), and Hospital Universitario La Paz (J.C.C.), Madrid - all in Spain; Kanagawa Cancer Center, Yokohama (S.M.), Kansai Medical University Hospital, Hirakata (T.K.), Kurume University Hospital, Kurume (T.T.), and Nippon Medical School Hospital, Tokyo (K.K.) - all in Japan; Westmead Hospital and the University of Sydney, Sydney (R.H.), and Flinders University and Flinders Medical Centre, Adelaide, SA (C.S.K.) - all in Australia; Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju (K.H.L.), Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (B.C.C.), and Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju (Y.-C.K.) - all in South Korea; Vivantes Klinikum Neukoelln, Berlin (M.W.), and the Lung Clinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Centre Hospitalier Universitaire de Liège, Liège (M.B.), and University Hospitals KU Leuven, Leuven (J.V.) - both in Belgium; Centre Hospitalier Universitaire de Montpellier and Institut du Cancer de Montpellier Val d'Aurelle, Montpellier (X.Q.), Institut Gustave Roussy, Villejuif (D.P.), and Institut de Cancérologie de l'Ouest-site René Gauducheau, Saint Herblain (S.H.) - all in France; National Koranyi Institute of Pulmonology, Budapest, Hungary (G.O.); the University of Manchester and the Christie NHS Foundation Trust, Manchester (C.F.-F.), AstraZeneca, Alderley Park (C.W.), and AstraZeneca, Cambridge (M.T.) - all in the United Kingdom; AstraZeneca, Gaithersburg, MD (G.M., P.A.D.); and Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey (M.Ö.)
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Raben D, Faivre-Finn C, Spigel D, Daniel D, Villegas A, Vincente D, Hui R, de Castro Carpeno J, Murakami S, Paz-Ares L, Özgüroğlu M, Kurata T, Chiappori A, Lee K, de Wit M, Poole L, Wadsworth C, Dennis P, Antonia S. PACIFIC: Overall Survival with Durvalumab versus Placebo after Chemoradiotherapy in Stage III NSCLC. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.08.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Spigel D, Vansteenkiste J, Reck M, Wakelee H, Özgüroğlu M, Daniel D, Villegas A, Vicente D, Hui R, Murakami S, Paz-Ares L, Poole L, Wadsworth C, Dennis P, Antonia S. P1.16-05 Effect of Induction Chemotherapy in the PACIFIC Study. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Cappuzzo F, McCleod M, Hussein M, Morabito A, Rittmeyer A, Conter H, Kopp HG, Daniel D, McCune S, Mekhail T, Zer A, Reinmuth N, Sadiq A, Archer V, Ochi Lohmann T, Wang L, Kowanetz M, Lin W, Sandler A, West H. IMpower130: Progression-free survival (PFS) and safety analysis from a randomised phase III study of carboplatin + nab-paclitaxel (CnP) with or without atezolizumab (atezo) as first-line (1L) therapy in advanced non-squamous NSCLC. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.065] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Spigel D, Jotte R, Ponce Aix S, Gressot L, Morgensztern D, McCleod M, Socinski M, Daniel D, Juan-Vidal O, Kim E, West H, Chen T, Bhore R, Ong T, Gridelli C, Thomas M. nab-paclitaxel + carboplatin induction followed by nab-paclitaxel maintenance in squamous non-small cell lung cancer (NSCLC): Results from the ABOUND.sqm study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Faivre-Finn C, Spigel D, Senan S, Langer C, Raben D, Perez B, Özgüroğlu M, Daniel D, Villegas A, Vicente D, Hui R, Murakami S, Paz-Ares L, Poole L, Wadsworth C, Dennis P, Antonia S. Efficacy and safety evaluation based on time from completion of radiotherapy to randomization with durvalumab or placebo in pts from PACIFIC. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy291] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Antonia S, Villegas A, Daniel D, Vicente D, Murakami S, Hui R, Kurata T, Chiappori A, Lee K, De Wit M, Cho B, Bourhaba M, Quantin X, Tokito T, Mekhail T, Planchard D, Kim Y, Karapetis C, Hiret S, Ostoros G, Kubota K, Gray J, Paz-Ares L, De Castro Carpeño J, Faivre-Finn C, Reck M, Vansteenkiste J, Spigel D, Wadsworth C, Taboada M, Dennis P, Özgüroğlu M. PL02.01 Overall Survival with Durvalumab Versus Placebo After Chemoradiotherapy in Stage III NSCLC: Updated Results from PACIFIC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Socinski M, Özgüroğlu M, Villegas A, Daniel D, Vicente D, Murakami S, Hui R, Gray J, Park K, Vincent M, Perrone F, Poole L, Wadsworth C, Dennis P, Antonia S. P1.16-04 Outcomes of Patients <70 or ≥70 Years of Age in PACIFIC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Subbaiyan K, Raghuram A, Ramaiah K, Mani R, Kathamuthu B, Daniel D, Nair R. Management of mechanical complications of acute myocardial infarction from a tier two city. J Cardiothorac Vasc Anesth 2018. [DOI: 10.1053/j.jvca.2018.08.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Hui R, Özgüroğlu M, Villegas A, Daniel D, Vicente D, Murakami S, Rydén A, Zhang Y, Dennis P, Antonia S. 233O Time to deterioration of symptoms with durvalumab in stage III, locally advanced, unresectable NSCLC: Post-hoc analysis of PACIFIC patient-reported outcomes. J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30401-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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